Provider Demographics
NPI:1285886838
Name:CHRISTIANSON, TAMARA J (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:J
Last Name:CHRISTIANSON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:NEW ENGLAND
Mailing Address - State:ND
Mailing Address - Zip Code:58647-0084
Mailing Address - Country:US
Mailing Address - Phone:701-290-4859
Mailing Address - Fax:
Practice Address - Street 1:1463 I94 BUSINESS LOOP E
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-6434
Practice Address - Country:US
Practice Address - Phone:701-227-7500
Practice Address - Fax:701-227-7575
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ND30001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator