Provider Demographics
NPI:1326232729
Name:SURERUS, CHRISTA RUTH (LPCC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTA
Middle Name:RUTH
Last Name:SURERUS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 10TH AVE S STE 212
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9481
Mailing Address - Country:US
Mailing Address - Phone:866-522-2472
Mailing Address - Fax:763-717-8049
Practice Address - Street 1:904 MAINSTREET STE 200
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-7589
Practice Address - Country:US
Practice Address - Phone:866-522-2472
Practice Address - Fax:763-717-8049
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00186101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health