Provider Demographics
NPI:1790106235
Name:CHRISTIAN, LARA LOUISE (MA, LPC, BCN)
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:LOUISE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:MA, LPC, BCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 FANNIN ST
Mailing Address - Street 2:SUITE 500A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-9143
Mailing Address - Country:US
Mailing Address - Phone:713-882-9370
Mailing Address - Fax:
Practice Address - Street 1:2302 FANNIN ST
Practice Address - Street 2:SUITE 500A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9143
Practice Address - Country:US
Practice Address - Phone:713-882-9370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-31
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75721101YP2500X
CO12696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional