Provider Demographics
NPI:1114545548
Name:ROBERTSON, CHRISTINA (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EAST ERIE ST
Mailing Address - Street 2:SUITE 525 PMB 4531
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:708-320-9224
Mailing Address - Fax:
Practice Address - Street 1:1 EAST ERIE ST
Practice Address - Street 2:SUITE 525 PMB 4531
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:708-320-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178015669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health