Provider Demographics
NPI:1578701660
Name:STORM, CRISTIEN V (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:CRISTIEN
Middle Name:V
Last Name:STORM
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-6007
Mailing Address - Country:US
Mailing Address - Phone:206-769-3160
Mailing Address - Fax:
Practice Address - Street 1:128 22ND AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-6007
Practice Address - Country:US
Practice Address - Phone:206-769-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 00010984101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health