Provider Demographics
NPI:1386281632
Name:CHRISTIE, KAITLIN PALMER RICE (LCSW)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:PALMER RICE
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 W FOREST MEADOWS ST STE 140
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-7226
Mailing Address - Country:US
Mailing Address - Phone:928-212-8621
Mailing Address - Fax:928-326-9114
Practice Address - Street 1:707 SABLE OAKS DR STE 230
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-6954
Practice Address - Country:US
Practice Address - Phone:207-774-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1041C0700X
MELC175661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical