Provider Demographics
NPI:1922490903
Name:ALEXANIAN, CHRISTINE G (LICSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:G
Last Name:ALEXANIAN
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 1:951 W EMMA AVE
Mailing Address - Street 2:APT. 13
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2584
Mailing Address - Country:US
Mailing Address - Phone:208-755-9474
Mailing Address - Fax:
Practice Address - Street 1:1101 S WESTCLIFF PL
Practice Address - Street 2:F-78
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-2018
Practice Address - Country:US
Practice Address - Phone:208-755-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 602986701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical