Provider Demographics
NPI:1043836604
Name:CHRISTOPHER, DEANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEANNE
Middle Name:
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8797 HARLOW LN
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-1506
Mailing Address - Country:US
Mailing Address - Phone:585-329-3358
Mailing Address - Fax:
Practice Address - Street 1:8797 HARLOW LN
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-1506
Practice Address - Country:US
Practice Address - Phone:585-329-3358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078266104100000X
NY094174011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker