Provider Demographics
NPI:1528505971
Name:JACOBSEN, CHRISTINE ANETTE (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANETTE
Last Name:JACOBSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 N POST OAK RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3841
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:720 N POST OAK RD
Practice Address - Street 2:SUITE 280
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3841
Practice Address - Country:US
Practice Address - Phone:713-314-7659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70377101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health