Provider Demographics
NPI:1114713856
Name:RENE, CHRISTLIE A
Entity type:Individual
Prefix:
First Name:CHRISTLIE
Middle Name:A
Last Name:RENE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CHRISTLIE
Other - Middle Name:A
Other - Last Name:NAPOLEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 14TH ST NE
Mailing Address - Street 2:
Mailing Address - City:EAST GRAND FORKS
Mailing Address - State:MN
Mailing Address - Zip Code:56721-1626
Mailing Address - Country:US
Mailing Address - Phone:218-693-2014
Mailing Address - Fax:218-693-2016
Practice Address - Street 1:203 14TH ST NE
Practice Address - Street 2:
Practice Address - City:EAST GRAND FORKS
Practice Address - State:MN
Practice Address - Zip Code:56721-1626
Practice Address - Country:US
Practice Address - Phone:218-693-2014
Practice Address - Fax:218-693-2016
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist