Provider Demographics
NPI:1972534543
Name:CHRISTIANSEN, ROBERT PURCELL (MS, CAP)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:PURCELL
Last Name:CHRISTIANSEN
Suffix:
Gender:M
Credentials:MS, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 S OAKHURST DR
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34446-1432
Mailing Address - Country:US
Mailing Address - Phone:352-628-0071
Mailing Address - Fax:
Practice Address - Street 1:3238 SOUTH LECANTO HIGHWAY, BOX 131
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461
Practice Address - Country:US
Practice Address - Phone:352-628-5020
Practice Address - Fax:352-628-5459
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 1552101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)