Provider Demographics
NPI:1427004878
Name:CHRISTIE, COLLEEN JORDAN (LPC & LMFT)
Entity Type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:JORDAN
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:LPC & LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1709
Mailing Address - Country:US
Mailing Address - Phone:409-782-3945
Mailing Address - Fax:409-994-2966
Practice Address - Street 1:1521 GREEN OAK PL
Practice Address - Street 2:SUITE 208
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77339-2057
Practice Address - Country:US
Practice Address - Phone:281-361-8001
Practice Address - Fax:409-994-2966
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3149101YP2500X
TX0966106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist