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NPI Code Detail

MEDICARE: CHRISTINA J WILLIS LPC

MEDICARE: CHRISTINA J WILLIS LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor8222SC

General Provider Information

NPI Number : 1770319402
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA J WILLIS LPC
Provider Business Mailing Address
First Line : PO BOX 735566
Second Line :
City : DALLAS
State : TX
Zip : 75373-5566
Country : US
Telephone Number : 800-288-7750
Fax Number :
Provider Business Practice Location Address
First Line : 5050 QUORUM DR STE 700
Second Line :
City : DALLAS
State : TX
Zip : 75254-1410
Country : US
Telephone Number : 800-288-7750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2024
Last Update Date : 03/25/2026

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Directions to “ CHRISTINA J WILLIS LPC” Practice Location

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