Provider Demographics
NPI:1669601589
Name:CHRISTENSEN II INC, BARBARA RA (LPC-MH)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:RA
Last Name:CHRISTENSEN II INC
Suffix:
Gender:F
Credentials:LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6809 S MINNESOTA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2570
Mailing Address - Country:US
Mailing Address - Phone:605-362-5803
Mailing Address - Fax:
Practice Address - Street 1:6809 S MINNESOTA AVE STE 102
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2570
Practice Address - Country:US
Practice Address - Phone:605-362-5803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD06111291101YA0400X
SDLPC-MH 2164101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6576710Medicaid