Provider Demographics
NPI:1174670780
Name:SALEM, CHRISTINA M (LPCC-S)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:M
Last Name:SALEM
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:MS
Other - First Name:CHRIS
Other - Middle Name:M
Other - Last Name:SALEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPCC-S
Mailing Address - Street 1:3017 FARNHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44286-9687
Mailing Address - Country:US
Mailing Address - Phone:216-496-9467
Mailing Address - Fax:
Practice Address - Street 1:3929 ROCKY RIVER DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-4153
Practice Address - Country:US
Practice Address - Phone:440-332-4245
Practice Address - Fax:216-252-9055
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE0003871OtherLPCC