Provider Demographics
NPI:1013170471
Name:PICKREN, CHRISTI ANNE (LMHC)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:ANNE
Last Name:PICKREN
Suffix:
Gender:F
Credentials:LMHC
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 241
Mailing Address - Street 2:
Mailing Address - City:RIBERA
Mailing Address - State:NM
Mailing Address - Zip Code:87560-0241
Mailing Address - Country:US
Mailing Address - Phone:919-971-6363
Mailing Address - Fax:
Practice Address - Street 1:1000 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-9415
Practice Address - Country:US
Practice Address - Phone:505-454-9738
Practice Address - Fax:505-425-9285
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0114641101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health