Provider Demographics
NPI:1821512377
Name:HERRERA, CHRISTINEE MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINEE
Middle Name:MARIE
Last Name:HERRERA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2032
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85001-2032
Mailing Address - Country:US
Mailing Address - Phone:602-358-0410
Mailing Address - Fax:602-353-0715
Practice Address - Street 1:3001 N 33RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-5202
Practice Address - Country:US
Practice Address - Phone:602-358-0410
Practice Address - Fax:602-353-0715
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16639101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health