Provider Demographics
NPI:1912463878
Name:CHRISTENSEN, HALAINA IRENE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:HALAINA
Middle Name:IRENE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:HALAINA
Other - Middle Name:IRENE
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5796 180TH ST W
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-8890
Mailing Address - Country:US
Mailing Address - Phone:651-249-6579
Mailing Address - Fax:
Practice Address - Street 1:2930 146TH ST W
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-3189
Practice Address - Country:US
Practice Address - Phone:952-443-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN244421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty