Provider Demographics
NPI:1710080312
Name:CHRISTENSEN, DOREEN ELLEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DOREEN
Middle Name:ELLEN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 NORTH COLLINS BOULEVARD
Mailing Address - Street 2:SUITE 509
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080
Mailing Address - Country:US
Mailing Address - Phone:972-231-5711
Mailing Address - Fax:972-234-2898
Practice Address - Street 1:2007 NORTH COLLINS BOULEVARD
Practice Address - Street 2:SUITE 509
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:972-231-5711
Practice Address - Fax:972-234-2898
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS123921041C0700X
TX001562042758106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
10772106OtherCAQH
TX00S19TMedicare ID - Type Unspecified
10772106OtherCAQH