Individual
CHRISTINE SUSAN MAIN
Active
Individual
CHRISTINE SUSAN MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCAS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2083
NC
1041C0700X
Clinical Social Worker
Primary
C007922
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2083
LICENSE
NC
01
—
C007922
LICENSE
NC
Enumeration date
09/06/2012
Last updated
09/06/2012
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