Provider Demographics
NPI:1285032706
Name:CIRCELLO, CHRISTINE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CIRCELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:CIRCELLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BA PSYCHOLOGY
Mailing Address - Street 1:1316 HAMMOND RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2360
Mailing Address - Country:US
Mailing Address - Phone:609-658-6049
Mailing Address - Fax:856-482-8420
Practice Address - Street 1:1316 HAMMOND RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2360
Practice Address - Country:US
Practice Address - Phone:609-658-6049
Practice Address - Fax:856-482-8420
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health