Provider Demographics
NPI:1952672347
Name:SISTRUNK, CHRISTEN (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTEN
Middle Name:
Last Name:SISTRUNK
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 1:1401 CASTLE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5703
Mailing Address - Country:US
Mailing Address - Phone:713-526-5055
Mailing Address - Fax:713-526-3226
Practice Address - Street 1:1401 CASTLE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5703
Practice Address - Country:US
Practice Address - Phone:713-526-5055
Practice Address - Fax:713-526-3226
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68426101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health