Provider Demographics
NPI:1750158143
Name:LIDEN, CHRISTY (MSW INTERN)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:LIDEN
Suffix:
Gender:F
Credentials:MSW INTERN
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 38
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-0038
Mailing Address - Country:US
Mailing Address - Phone:970-261-5899
Mailing Address - Fax:
Practice Address - Street 1:1451 O RD
Practice Address - Street 2:
Practice Address - City:LOMA
Practice Address - State:CO
Practice Address - Zip Code:81524-9410
Practice Address - Country:US
Practice Address - Phone:970-261-5899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool