Provider Demographics
NPI:1447690409
Name:CHRISTMAS, CATHY (LCSW)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:CHRISTMAS
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 1:35106 ROTH LN
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-0408
Mailing Address - Country:US
Mailing Address - Phone:813-416-3563
Mailing Address - Fax:
Practice Address - Street 1:401 CORBETT ST
Practice Address - Street 2:340B
Practice Address - City:BELLEAIR
Practice Address - State:FL
Practice Address - Zip Code:33756-7309
Practice Address - Country:US
Practice Address - Phone:813-416-3563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-04
Last Update Date:2013-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW113641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical