Provider Demographics
NPI:1467053884
Name:PARTIN, CHRISTOPHER (PLMHP, PLADAC, PSW)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:PARTIN
Suffix:
Gender:M
Credentials:PLMHP, PLADAC, PSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 WEST 2ND STREET, SUITE 450
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803
Mailing Address - Country:US
Mailing Address - Phone:402-705-3684
Mailing Address - Fax:308-384-0194
Practice Address - Street 1:1811 WEST 2ND STREET, SUITE 450
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803
Practice Address - Country:US
Practice Address - Phone:402-705-3684
Practice Address - Fax:308-384-0194
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1697101YM0800X
NEPMSW7282101YM0800X
NEPMHP11626101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health