Provider Demographics
NPI:1588899942
Name:WARD, CHRISTINA MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:WARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:ST.CLAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3128 CREEK VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-8715
Mailing Address - Country:US
Mailing Address - Phone:904-747-0847
Mailing Address - Fax:904-621-9140
Practice Address - Street 1:3128 CREEK VILLAGE LN
Practice Address - Street 2:
Practice Address - City:GREEN COVE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32043-8715
Practice Address - Country:US
Practice Address - Phone:904-747-0847
Practice Address - Fax:904-621-9140
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW90111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical