Provider Demographics
NPI:1770249922
Name:BIRGEN, CHRISTINA (LPC, LMFT-A)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BIRGEN
Suffix:
Gender:F
Credentials:LPC, LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 BOONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77808-2326
Mailing Address - Country:US
Mailing Address - Phone:979-703-1808
Mailing Address - Fax:
Practice Address - Street 1:2490 BOONVILLE RD
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77808-2326
Practice Address - Country:US
Practice Address - Phone:979-703-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78727101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health