Provider Demographics
NPI:1053550822
Name:DURBIN, CHRISTINE JELSING (LPCC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:JELSING
Last Name:DURBIN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-5336
Mailing Address - Country:US
Mailing Address - Phone:651-228-4011
Mailing Address - Fax:
Practice Address - Street 1:1100 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-5336
Practice Address - Country:US
Practice Address - Phone:651-228-4011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
OK4731283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No283Q00000XHospitalsPsychiatric Hospital