Provider Demographics
NPI:1972871168
Name:EVENSEN, CHRISTINA A (LPC, NCC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
Last Name:EVENSEN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:CHRISSY
Other - Middle Name:A
Other - Last Name:EVENSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, NCC
Mailing Address - Street 1:11141 ZEALAND AVE N
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-3595
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11141 ZEALAND AVE N
Practice Address - Street 2:
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-3595
Practice Address - Country:US
Practice Address - Phone:763-951-3091
Practice Address - Fax:763-951-3097
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional