Provider Demographics
NPI:1093089443
Name:TOLLAND, CHRISTOPHER LAWRENCE (LPC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:LAWRENCE
Last Name:TOLLAND
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8217 EDGEMERE BLVD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3840
Mailing Address - Country:US
Mailing Address - Phone:915-760-0320
Mailing Address - Fax:
Practice Address - Street 1:101 MAGUEY CT STE 1
Practice Address - Street 2:
Practice Address - City:SUNLAND PARK
Practice Address - State:NM
Practice Address - Zip Code:88063-9513
Practice Address - Country:US
Practice Address - Phone:575-589-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX66072OtherTEXAS LICENSE PROFESSIONAL COUNSELOR