Provider Demographics
NPI:1609665991
Name:CONNELL, CHRISTIAN FRANK (LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:FRANK
Last Name:CONNELL
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12225 SE WIESE RD
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:OR
Mailing Address - Zip Code:97089-8354
Mailing Address - Country:US
Mailing Address - Phone:971-404-5123
Mailing Address - Fax:
Practice Address - Street 1:2614 FORT VANCOUVER WAY STE D
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3971
Practice Address - Country:US
Practice Address - Phone:360-696-4895
Practice Address - Fax:360-696-4044
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61252438101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health