Provider Demographics
NPI:1821509282
Name:HUBBELL, CHRISTINA MARIE (LPCC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE
Last Name:HUBBELL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13637 60TH ST SW
Mailing Address - Street 2:
Mailing Address - City:COKATO
Mailing Address - State:MN
Mailing Address - Zip Code:55321-4210
Mailing Address - Country:US
Mailing Address - Phone:320-286-2922
Mailing Address - Fax:320-286-2875
Practice Address - Street 1:13637 60TH ST SW
Practice Address - Street 2:
Practice Address - City:COKATO
Practice Address - State:MN
Practice Address - Zip Code:55321-4210
Practice Address - Country:US
Practice Address - Phone:320-286-2922
Practice Address - Fax:320-286-2875
Is Sole Proprietor?:No
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01643101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01643OtherBOARD OF BEHAVIORAL HEALTH & THERAPY