Provider Demographics
NPI:1427328475
Name:CULL, CHRISTY JOY
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:JOY
Last Name:CULL
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CHRISTY
Other - Middle Name:JOY
Other - Last Name:CULL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCA
Mailing Address - Street 1:233 IVY STONE DR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-7386
Mailing Address - Country:US
Mailing Address - Phone:724-984-2094
Mailing Address - Fax:
Practice Address - Street 1:901 ARSENAL AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5398
Practice Address - Country:US
Practice Address - Phone:910-486-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9142101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health