Provider Demographics
NPI:1497936264
Name:CHRISTIAN, AMY MARIE (LPC, CRC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARIE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:DENDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, CRC
Mailing Address - Street 1:309 EAST ST.VRAIN STREET
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903
Mailing Address - Country:US
Mailing Address - Phone:719-473-9200
Mailing Address - Fax:719-473-9203
Practice Address - Street 1:309 EAST ST.VRAIN STREET
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903
Practice Address - Country:US
Practice Address - Phone:719-473-9200
Practice Address - Fax:719-473-9203
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1243101YP2500X
CO11265101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional