Provider Demographics
NPI:1972016269
Name:RIOS, CHRISTINA (LLMSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:RIOS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:BULLMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 30161
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909-7661
Mailing Address - Country:US
Mailing Address - Phone:517-244-8019
Mailing Address - Fax:517-244-7174
Practice Address - Street 1:220 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1515
Practice Address - Country:US
Practice Address - Phone:517-244-8014
Practice Address - Fax:517-244-7188
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010884131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical