Provider Demographics
NPI:1033851878
Name:MONTELIUS, CORINNE (LPC)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:MONTELIUS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:
Other - Last Name:RUSNOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:PO BOX 313
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07946-0313
Mailing Address - Country:US
Mailing Address - Phone:908-809-9463
Mailing Address - Fax:
Practice Address - Street 1:1390 VALLEY RD STE 1D
Practice Address - Street 2:
Practice Address - City:STIRLING
Practice Address - State:NJ
Practice Address - Zip Code:07980-1346
Practice Address - Country:US
Practice Address - Phone:908-809-9463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00856500101YP2500X
101YP2500X
NJ37AC00470000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional