Provider Demographics
NPI:1528332798
Name:WHISNAND, CHRISTOPHER GUY (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GUY
Last Name:WHISNAND
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 OVILLA OAKS DR
Mailing Address - Street 2:
Mailing Address - City:OVILLA
Mailing Address - State:TX
Mailing Address - Zip Code:75154-5616
Mailing Address - Country:US
Mailing Address - Phone:214-708-4204
Mailing Address - Fax:
Practice Address - Street 1:404 OVILLA OAKS DR
Practice Address - Street 2:
Practice Address - City:OVILLA
Practice Address - State:TX
Practice Address - Zip Code:75154-5616
Practice Address - Country:US
Practice Address - Phone:214-708-4204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65937101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2906315-01Medicaid