Provider Demographics
NPI:1053198952
Name:DEVEREAUX, CHRISTINA (LPC, LMHC, LCAT)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:DEVEREAUX
Suffix:
Gender:F
Credentials:LPC, LMHC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1109
Mailing Address - Country:US
Mailing Address - Phone:631-885-0212
Mailing Address - Fax:
Practice Address - Street 1:780 GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-1109
Practice Address - Country:US
Practice Address - Phone:631-885-0212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000993101YM0800X
PAPC016125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health