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General NPI Number Information
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NPI Number | 1346538436
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER MINISTRIES, INC.
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 01/06/2016
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Provider Practice Location Address
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Address Line | 313B W DIVISION ST
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City | MOUNT JULIET
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State | TN
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Zip | 37122-3207
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Country | US
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Telephone | 615-636-7414
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Fax | 866-799-4512
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Provider Business Mailing Address
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Address Line | PO BOX 555
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City | MOUNT JULIET
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State | TN
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Zip | 37121-0555
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Country | US
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Telephone | 615-636-7414
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Fax | 866-799-4512
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TRACIA H JUNGKURTH
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Credential | PHD,LPC,LMHC,SAP
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Telephone | 615-636-7414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH9523
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License Number State | FL
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