Provider Demographics
NPI:1407302599
Name:LAPILA, CHRISTINE
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:LAPILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 TULANE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-3237
Mailing Address - Country:US
Mailing Address - Phone:386-500-8589
Mailing Address - Fax:
Practice Address - Street 1:104 LACOSTA LN
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-8159
Practice Address - Country:US
Practice Address - Phone:386-500-8589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-29
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCM.0107693-P171M00000X
FLCRPS100312-F101YM0800X
104100000X
FL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCRPS100312FOtherCERTIFICATE
FLCBHCM.0107693-POtherCERTIFICATE
FL222Q00000XMedicaid