Provider Demographics
NPI:1922430263
Name:RUNNELS, CHRISTINA ALYCE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ALYCE
Last Name:RUNNELS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25527 MYRTLE SPGS
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-8109
Mailing Address - Country:US
Mailing Address - Phone:281-635-0998
Mailing Address - Fax:
Practice Address - Street 1:1319 LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77003-4408
Practice Address - Country:US
Practice Address - Phone:281-635-0998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68799101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional