Provider Demographics
NPI:1548759236
Name:CHRISTIE, JOEL STEPHEN (LPC)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:STEPHEN
Last Name:CHRISTIE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 UNION AVE. SE, SUITE A
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-2810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:616-942-0589
Practice Address - Street 1:2080 UNION AVE. SE, SUITE A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-4950
Practice Address - Country:US
Practice Address - Phone:616-295-0986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017395101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health