Healthcare Provider Details

I. General information

NPI: 1629963061
Provider Name (Legal Business Name): CHRISTIE EARNHEART LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 CANYON LAKE CIR
LUMBERTON TX
77657-3701
US

IV. Provider business mailing address

5405 LEXINGTON CIR
LUMBERTON TX
77657-5964
US

V. Phone/Fax

Practice location:
  • Phone: 409-200-2220
  • Fax:
Mailing address:
  • Phone: 409-656-1114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number98964
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: