Provider Demographics
NPI:1871926717
Name:GELINAS, CHRISTINE JEAN
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:JEAN
Last Name:GELINAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:JEAN
Other - Last Name:COSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:543 NORTH ST
Mailing Address - Street 2:ATTN: CHILD AND FAMILY EMERGENCY SERVICES
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-2782
Mailing Address - Country:US
Mailing Address - Phone:508-996-3154
Mailing Address - Fax:508-991-8082
Practice Address - Street 1:543 NORTH ST
Practice Address - Street 2:ATTN: CHILD AND FAMILY EMERGENCY SERVICES
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-2782
Practice Address - Country:US
Practice Address - Phone:508-996-3154
Practice Address - Fax:508-991-8082
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1192861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical