Healthcare Provider Details
I. General information
NPI: 1306650395
Provider Name (Legal Business Name): CHRISTINE ELIZABETH AMERSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5522 LONE STAR PKWY STE 303
SAN ANTONIO TX
78253
US
IV. Provider business mailing address
5522 LONE STAR PKWY STE 303
SAN ANTONIO TX
78253
US
V. Phone/Fax
- Phone: 210-664-1275
- Fax:
- Phone: 210-664-1275
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 85158 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 85158 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: