Provider Demographics
NPI:1558675223
Name:CHRISTENSEN, TYSON LUND (LCSW)
Entity type:Individual
Prefix:
First Name:TYSON
Middle Name:LUND
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2849
Mailing Address - Country:US
Mailing Address - Phone:607-737-4832
Mailing Address - Fax:607-737-4857
Practice Address - Street 1:100 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2849
Practice Address - Country:US
Practice Address - Phone:607-737-4832
Practice Address - Fax:607-737-4875
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094697011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical