Provider Demographics
NPI:1245574334
Name:CRISTOFANO, DANIELLE C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:C
Last Name:CRISTOFANO
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 1:2160 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1203
Mailing Address - Country:US
Mailing Address - Phone:732-778-0440
Mailing Address - Fax:
Practice Address - Street 1:55 ROUTE 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5918
Practice Address - Country:US
Practice Address - Phone:732-704-4640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056069001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical