Provider Demographics
NPI:1528349610
Name:FERRELL, CHRISTINA ROSE (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ROSE
Last Name:FERRELL
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 1:137 LAXTON RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-3144
Mailing Address - Country:US
Mailing Address - Phone:914-466-8495
Mailing Address - Fax:
Practice Address - Street 1:137 LAXTON RD
Practice Address - Street 2:SUITE 250
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-3144
Practice Address - Country:US
Practice Address - Phone:914-466-8495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040077381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical