Provider Demographics
NPI:1144744285
Name:VECCHIARELLI, CHRISTINA (LAC, LCADC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:VECCHIARELLI
Suffix:
Gender:F
Credentials:LAC, LCADC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:ELIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC, LCADC
Mailing Address - Street 1:256 COLUMBIA TPKE STE 100N
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1238
Mailing Address - Country:US
Mailing Address - Phone:973-593-0090
Mailing Address - Fax:
Practice Address - Street 1:256 COLUMBIA TPKE
Practice Address - Street 2:SUITE 100N
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932
Practice Address - Country:US
Practice Address - Phone:973-593-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00348000101YM0800X
NJ37LC00241800101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health