Provider Demographics
NPI:1568085868
Name:WELLMAN, CHRISTI MICHELLE (LPCC AND LADC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTI
Middle Name:MICHELLE
Last Name:WELLMAN
Suffix:
Gender:F
Credentials:LPCC AND LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11725 STINSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55013
Mailing Address - Country:US
Mailing Address - Phone:651-213-8051
Mailing Address - Fax:651-257-9237
Practice Address - Street 1:11725 STINSON AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO CITY
Practice Address - State:MN
Practice Address - Zip Code:55013
Practice Address - Country:US
Practice Address - Phone:651-213-8051
Practice Address - Fax:651-257-9237
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN304539101YA0400X
MNCC00281101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty