Provider Demographics
NPI:1285191312
Name:ERLENBUSH, CHRISTIAN ERIC (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:ERIC
Last Name:ERLENBUSH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 E TAHQUITZ CANYON WAY SUITE 200
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6982
Mailing Address - Country:US
Mailing Address - Phone:760-620-5554
Mailing Address - Fax:
Practice Address - Street 1:3001 E TAHQUITZ CANYON WAY
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6982
Practice Address - Country:US
Practice Address - Phone:760-620-5554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA829561041C0700X
IL149.0208771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical