Healthcare Provider Details

I. General information

NPI: 1669704102
Provider Name (Legal Business Name): RYAN JAMES CHRISTENSEN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 EAST 1400 SOUTH
OREM UT
84097
US

IV. Provider business mailing address

570 EAST 1400 SOUTH
OREM UT
84097
US

V. Phone/Fax

Practice location:
  • Phone: 801-426-6661
  • Fax: 801-426-6660
Mailing address:
  • Phone: 801-426-6661
  • Fax: 801-426-6660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number353763-6004
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: