Provider Demographics
NPI:1861528150
Name:PICHETTE, CHRISTY RENEE (BS, CDCI)
Entity type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:RENEE
Last Name:PICHETTE
Suffix:
Gender:F
Credentials:BS, CDCI
Other - Prefix:MS
Other - First Name:CHRISTY
Other - Middle Name:RENEE
Other - Last Name:PICHETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ECT
Mailing Address - Street 1:1345 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-5709
Mailing Address - Country:US
Mailing Address - Phone:907-347-2407
Mailing Address - Fax:
Practice Address - Street 1:1345 HOLMES RD
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-5709
Practice Address - Country:US
Practice Address - Phone:907-347-2407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3137101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)