Provider Demographics
NPI:1285191312
Name:ERLENBUSH, CHRISTIAN ERIC (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:ERIC
Last Name:ERLENBUSH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 E TAHQUITZ CANYON WAY STE 5
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6817
Mailing Address - Country:US
Mailing Address - Phone:949-603-2314
Mailing Address - Fax:949-619-8133
Practice Address - Street 1:2150 E TAHQUITZ CANYON WAY STE 5
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6817
Practice Address - Country:US
Practice Address - Phone:949-603-2314
Practice Address - Fax:949-619-8133
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0208771041C0700X
CA829561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical