Provider Demographics
NPI:1740771112
Name:READER, CHRISTA JOYCE (LICSW)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:JOYCE
Last Name:READER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5775 WAYZATA BLVD STE 255
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1275
Mailing Address - Country:US
Mailing Address - Phone:952-525-4512
Mailing Address - Fax:952-525-1560
Practice Address - Street 1:5775 WAYZATA BLVD STE 255
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1275
Practice Address - Country:US
Practice Address - Phone:952-525-4512
Practice Address - Fax:952-525-1560
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN224821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical