Provider Demographics
NPI:1053823955
Name:FIKE, CHRISTINA J (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:J
Last Name:FIKE
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:J
Other - Last Name:BERLINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2405 8TH ST S STE 200
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-4200
Mailing Address - Country:US
Mailing Address - Phone:218-331-4866
Mailing Address - Fax:
Practice Address - Street 1:2405 8TH ST S STE 200
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-4224
Practice Address - Country:US
Practice Address - Phone:218-331-4866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1811101YP2500X
MNCC01660101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional