Provider Demographics
NPI:1093221277
Name:MOLINA, CHRISTINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11601 FRUITWOOD PL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-3575
Mailing Address - Country:US
Mailing Address - Phone:512-872-6003
Mailing Address - Fax:
Practice Address - Street 1:11601 FRUITWOOD PL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-3575
Practice Address - Country:US
Practice Address - Phone:512-872-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-24
Last Update Date:2023-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX589871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical