Provider Demographics
NPI:1174690556
Name:ELGIN, CHRISTOPHER SCOT (MA LPC CADCI)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:SCOT
Last Name:ELGIN
Suffix:
Gender:M
Credentials:MA LPC CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ELLSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321
Mailing Address - Country:US
Mailing Address - Phone:541-760-5107
Mailing Address - Fax:541-924-9600
Practice Address - Street 1:425 ELLSWORTH ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321
Practice Address - Country:US
Practice Address - Phone:541-760-5107
Practice Address - Fax:541-924-9600
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1525101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR128715Medicaid