Provider Demographics
NPI:1023985611
Name:STAEBELL, CHRISTINE (LP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:STAEBELL
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-3739
Mailing Address - Country:US
Mailing Address - Phone:651-336-8128
Mailing Address - Fax:866-627-0910
Practice Address - Street 1:900 LONG LAKE RD
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-6428
Practice Address - Country:US
Practice Address - Phone:612-900-0233
Practice Address - Fax:866-627-0910
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP7280103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling