Provider Demographics
NPI:1841694700
Name:ZIVEC, CHRISTINA MICHELLE (MA, LCPC)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MICHELLE
Last Name:ZIVEC
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:MICHELLE
Other - Last Name:ROLIH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 W 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-3012
Mailing Address - Country:US
Mailing Address - Phone:630-379-1602
Mailing Address - Fax:815-929-1284
Practice Address - Street 1:203 W 20TH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-3012
Practice Address - Country:US
Practice Address - Phone:630-379-1602
Practice Address - Fax:815-929-1284
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-21
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009737101YM0800X
KS03778101YM0800X
NE3751101YM0800X
IN39004980A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL12801393OtherCAQH