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General NPI Number Information
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NPI Number | 1164938981
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Entity Type | Individual
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Provider Name | CHRISTINA CABURNAY LU LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/15/2017
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | GROW THERAPY 141 WEST 24TH STREET
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 312-585-6513
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Fax |
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Provider Business Mailing Address
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Address Line | 6977 W OAKTON ST #480472
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City | NILES
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State | IL
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Zip | 60714
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Country | US
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Telephone | 312-585-6513
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166001155
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License Number State | IL
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