Provider Demographics
NPI:1316953482
Name:ABBOTT, CHRISTOPHER HUNTERA (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:HUNTERA
Last Name:ABBOTT
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E WILSON BLVD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-7412
Mailing Address - Country:US
Mailing Address - Phone:240-527-1414
Mailing Address - Fax:
Practice Address - Street 1:13102 GRANT SHOOK RD
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225-8686
Practice Address - Country:US
Practice Address - Phone:240-527-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD063461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDPHCS 2235067OtherPHCS
MD000395600Medicaid
MD121741OtherJOHN HOPKINS HEALTHCARE
MD614440-01OtherBCBS
MD000395600Medicaid