Provider Demographics
NPI:1861782609
Name:FARRIS, CHRISTIE L (MA, LPC-I, LMFT-A)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:L
Last Name:FARRIS
Suffix:
Gender:F
Credentials:MA, LPC-I, LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 HAWKHURST CIR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-3292
Mailing Address - Country:US
Mailing Address - Phone:832-752-0706
Mailing Address - Fax:
Practice Address - Street 1:1610 WOODSTEAD CT
Practice Address - Street 2:SUITE 420
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3413
Practice Address - Country:US
Practice Address - Phone:281-363-4220
Practice Address - Fax:281-364-9404
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64690101YP2500X
TX201304106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist