Provider Demographics
NPI:1164301123
Name:WILLIAMS, CHRISTINA IVIOSE IRVIN (MA, LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:IVIOSE IRVIN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 WATERFORD OAK DR APT 106
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-5983
Mailing Address - Country:US
Mailing Address - Phone:860-808-8410
Mailing Address - Fax:
Practice Address - Street 1:8400 RED BUG LAKE RD STE 2080
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6835
Practice Address - Country:US
Practice Address - Phone:877-610-6979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH26292101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty