Provider Demographics
NPI:1194734905
Name:PAUL, CHRISTINA LYNN (LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNN
Last Name:PAUL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3574 US 1 S
Mailing Address - Street 2:UNIT 113
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-6466
Mailing Address - Country:US
Mailing Address - Phone:904-797-3115
Mailing Address - Fax:904-797-2915
Practice Address - Street 1:3574 US 1 S
Practice Address - Street 2:UNIT 113
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-6466
Practice Address - Country:US
Practice Address - Phone:904-797-3115
Practice Address - Fax:904-797-2915
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8666101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ119NOtherBCBS OF FL
FL767655700Medicaid
FL767655700Medicaid