Provider Demographics
NPI:1407380066
Name:STROVEN, CHRISTOPHER MATTHEW (LLPC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MATTHEW
Last Name:STROVEN
Suffix:
Gender:M
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 W CENTRE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5344
Mailing Address - Country:US
Mailing Address - Phone:269-359-7115
Mailing Address - Fax:
Practice Address - Street 1:1611 W CENTRE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5344
Practice Address - Country:US
Practice Address - Phone:269-359-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010924101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional