Provider Demographics
NPI:1538177209
Name:CHRISTIE, NANCY H (LPC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:H
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 940165
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75094-0165
Mailing Address - Country:US
Mailing Address - Phone:972-424-9212
Mailing Address - Fax:972-509-1450
Practice Address - Street 1:6040 CAMP BOWIE BLVD STE 28
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-5602
Practice Address - Country:US
Practice Address - Phone:972-424-9212
Practice Address - Fax:972-509-1450
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8388101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8388OtherSTATE LICENSE LPC
TX4044LCOtherBLUE CROSS
TX2271871OtherAETNA
TX2688OtherSTATE BIOFEEDBACK LICENSE