Provider Demographics
NPI:1982282695
Name:PAULSEN, CHRISTINA JOY (ALMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JOY
Last Name:PAULSEN
Suffix:
Gender:F
Credentials:ALMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27W741 HODGES WAY
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1727
Mailing Address - Country:US
Mailing Address - Phone:952-239-4322
Mailing Address - Fax:
Practice Address - Street 1:1400 LINCOLN HWY STE A
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-3580
Practice Address - Country:US
Practice Address - Phone:630-797-9872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.000867106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist