Provider Demographics
NPI:1255704557
Name:CARON, CHRISTINE (MS, LADC, LPCC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CARON
Suffix:
Gender:F
Credentials:MS, LADC, LPCC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2430 NICOLLET AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3461
Mailing Address - Country:US
Mailing Address - Phone:612-871-7443
Mailing Address - Fax:
Practice Address - Street 1:2430 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3461
Practice Address - Country:US
Practice Address - Phone:612-871-7443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN303486101YA0400X
MN1032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)