Provider Demographics
NPI:1255138780
Name:CHRISTEN, MAKAYLA MARIE (MS, LADC)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:MARIE
Last Name:CHRISTEN
Suffix:
Gender:
Credentials:MS, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 OAK ST
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-3610
Mailing Address - Country:US
Mailing Address - Phone:320-202-1400
Mailing Address - Fax:320-202-8662
Practice Address - Street 1:110 14TH AVE E
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4644
Practice Address - Country:US
Practice Address - Phone:320-202-1400
Practice Address - Fax:320-202-8662
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN307225101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)