Provider Demographics
NPI:1689735219
Name:HUTCHINSON, CHRISTINA GLORIA (LISW-CP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:GLORIA
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:HUTCHINSON
Other - Last Name:BUTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-CP
Mailing Address - Street 1:823 NEIGHBOR LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7961
Mailing Address - Country:US
Mailing Address - Phone:803-960-7394
Mailing Address - Fax:
Practice Address - Street 1:823 NEIGHBOR LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7961
Practice Address - Country:US
Practice Address - Phone:803-960-7394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
SC71321041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool