Provider Demographics
NPI:1578578373
Name:CHRISTINA P. RICH
Entity Type:Organization
Organization Name:CHRISTINA P. RICH
Other - Org Name:CPR COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:PAULINE
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-320-9969
Mailing Address - Street 1:PO BOX 483
Mailing Address - Street 2:
Mailing Address - City:TOKELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98590-0483
Mailing Address - Country:US
Mailing Address - Phone:360-581-9028
Mailing Address - Fax:360-679-2777
Practice Address - Street 1:1121 SE DOCK ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-4067
Practice Address - Country:US
Practice Address - Phone:360-581-9028
Practice Address - Fax:360-679-2777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2011-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000087211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty