Provider Demographics
NPI:1679883268
Name:UBBEN, CHRISTINE (MA LPCC LMFT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:UBBEN
Suffix:
Gender:F
Credentials:MA LPCC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17404 GLACIER WAY APT 104
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-6457
Mailing Address - Country:US
Mailing Address - Phone:952-431-1975
Mailing Address - Fax:
Practice Address - Street 1:17404 GLACIER WAY APT 104
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-6457
Practice Address - Country:US
Practice Address - Phone:952-431-1975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2091106H00000X
MN432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist