Provider Demographics
NPI:1932830551
Name:SEVERO, CHRISTINA A (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:A
Last Name:SEVERO
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 1:8009 CLOUDCROFT LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-3374
Mailing Address - Country:US
Mailing Address - Phone:239-677-9808
Mailing Address - Fax:
Practice Address - Street 1:8009 CLOUDCROFT LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-3374
Practice Address - Country:US
Practice Address - Phone:239-677-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2565341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical