Provider Demographics
NPI:1245639061
Name:CARRILLO, CHRISTINE CLARE (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CLARE
Last Name:CARRILLO
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:CLARE
Other - Last Name:MESSINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1520 E PIMA ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-4639
Mailing Address - Country:US
Mailing Address - Phone:480-831-4566
Mailing Address - Fax:
Practice Address - Street 1:1520 E PIMA ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-4639
Practice Address - Country:US
Practice Address - Phone:480-831-4566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-21582101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional