Provider Demographics
NPI:1538700208
Name:RICHARDSON, CHRISTINA HANSEN (LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:HANSEN
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7420 BLEASDALE CT
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-6212
Mailing Address - Country:US
Mailing Address - Phone:408-439-9403
Mailing Address - Fax:
Practice Address - Street 1:1601 JONES FRANKLIN RD STE 104
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-3379
Practice Address - Country:US
Practice Address - Phone:919-851-1527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12180A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist