Provider Demographics
NPI:1538283411
Name:CISSNER, CHRISTINE B (LPC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:B
Last Name:CISSNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 N PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64050-2660
Mailing Address - Country:US
Mailing Address - Phone:816-803-4944
Mailing Address - Fax:
Practice Address - Street 1:4401 NE VIVION RD STE 204
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-2800
Practice Address - Country:US
Practice Address - Phone:816-803-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002697101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health