Provider Demographics
NPI:1467040477
Name:PALLOTTA, CHRISTINA (LSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:PALLOTTA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:PALLOTTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:551 VALLEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1840
Mailing Address - Country:US
Mailing Address - Phone:347-233-0358
Mailing Address - Fax:
Practice Address - Street 1:773 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2528
Practice Address - Country:US
Practice Address - Phone:347-233-0358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health