Healthcare Provider Details

I. General information

NPI: 1700307675
Provider Name (Legal Business Name): CHRISTINE RIVER BLOCK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 AUGUSTA DR STE 290
HOUSTON TX
77057-2263
US

IV. Provider business mailing address

1220 AUGUSTA DR STE 290
HOUSTON TX
77057-2263
US

V. Phone/Fax

Practice location:
  • Phone: 713-428-8700
  • Fax: 346-646-5135
Mailing address:
  • Phone: 713-428-8700
  • Fax: 346-646-5135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number59916
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: