Healthcare Provider Details

I. General information

NPI: 1821827148
Provider Name (Legal Business Name): CHRISTIN TOLENTINO RN, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 JORI LN
SANDIA PARK NM
87047-9406
US

IV. Provider business mailing address

PO BOX 817
CEDAR CREST NM
87008-0817
US

V. Phone/Fax

Practice location:
  • Phone: 281-384-3348
  • Fax:
Mailing address:
  • Phone: 281-384-3348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0022675
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: