Provider Demographics
NPI:1982263869
Name:ALCENIUS, CHRISTINE REBEKAH (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:REBEKAH
Last Name:ALCENIUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:REBEKAH ALCENIUS
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:205 FISTRAL DR
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-5516
Mailing Address - Country:US
Mailing Address - Phone:512-203-0849
Mailing Address - Fax:
Practice Address - Street 1:555 ROUND ROCK WEST DR STE E214
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5052
Practice Address - Country:US
Practice Address - Phone:512-369-3110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX520591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty