Provider Demographics
NPI:1437464005
Name:KISS, CHRISTINE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:KISS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 BERMUDA DUNES DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2426
Mailing Address - Country:US
Mailing Address - Phone:281-352-3170
Mailing Address - Fax:
Practice Address - Street 1:2814 BERMUDA DUNES DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2426
Practice Address - Country:US
Practice Address - Phone:281-352-3170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-08
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX510441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical