Provider Demographics
NPI:1285736652
Name:CHRISTO, CECIL (LMSW)
Entity type:Individual
Prefix:MR
First Name:CECIL
Middle Name:
Last Name:CHRISTO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 RALEIGH AVE
Mailing Address - Street 2:APT 5
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-4159
Mailing Address - Country:US
Mailing Address - Phone:810-245-9396
Mailing Address - Fax:
Practice Address - Street 1:1800 IMLAY CITY RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3208
Practice Address - Country:US
Practice Address - Phone:810-245-5706
Practice Address - Fax:810-245-5676
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL903255101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)