Provider Demographics
NPI:1336944214
Name:VERNON, CHRISTINA JO (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JO
Last Name:VERNON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR LOCKS
Mailing Address - State:CT
Mailing Address - Zip Code:06096-2312
Mailing Address - Country:US
Mailing Address - Phone:860-792-1431
Mailing Address - Fax:
Practice Address - Street 1:37 CENTER ST
Practice Address - Street 2:
Practice Address - City:WINDSOR LOCKS
Practice Address - State:CT
Practice Address - Zip Code:06096-2312
Practice Address - Country:US
Practice Address - Phone:860-792-1431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT146141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical