Provider Demographics
NPI:1710349428
Name:CHRISTINE KALIE, LCC
Entity Type:Organization
Organization Name:CHRISTINE KALIE, LCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KALIE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:814-464-3958
Mailing Address - Street 1:2233 EBCO DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6919
Mailing Address - Country:US
Mailing Address - Phone:814-464-3958
Mailing Address - Fax:814-725-0707
Practice Address - Street 1:2233 EBCO DR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-6919
Practice Address - Country:US
Practice Address - Phone:814-464-3958
Practice Address - Fax:814-725-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007075101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty