Provider Demographics
NPI:1215524574
Name:CHRISTENSEN, ELISA (LPC)
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 30TH ST APT 5904
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3487
Mailing Address - Country:US
Mailing Address - Phone:210-980-0207
Mailing Address - Fax:
Practice Address - Street 1:6620 30TH ST APT 5904
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-3487
Practice Address - Country:US
Practice Address - Phone:210-980-0207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92190101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXRBT-20-138413OtherREGISTER BEHAVIORAL INNOVATION (RBT)