Provider Demographics
NPI:1811327232
Name:HOUSTON, CHRISTY (LMSW)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20476 ROSCOMMON ST
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-2259
Mailing Address - Country:US
Mailing Address - Phone:313-742-0206
Mailing Address - Fax:313-271-8353
Practice Address - Street 1:6 PARKLANE BLVD STE 695
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2776
Practice Address - Country:US
Practice Address - Phone:313-271-8170
Practice Address - Fax:313-271-8353
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-21
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MH68010939771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical