Basic Information
Provider Information
NPI: 1053980433
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCIPIO
FirstName: CHRISTINA
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: LSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1389 BRANDYWINE PL
Address2:  
City: ZANESVILLE
State: OH
PostalCode: 437011075
CountryCode: US
TelephoneNumber: 7406243166
FaxNumber:  
Practice Location
Address1: 1009 STEUBENVILLE AVE
Address2:  
City: CAMBRIDGE
State: OH
PostalCode: 437252401
CountryCode: US
TelephoneNumber: 7404394532
FaxNumber: 7404391031
Other Information
ProviderEnumerationDate: 06/21/2021
LastUpdateDate: 06/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XS.2106233OHY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home