Provider Demographics
NPI:1548229651
Name:BARDELLI, CHRISTINE B (MSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:B
Last Name:BARDELLI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 HIGHGROVE DR SE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-9288
Mailing Address - Country:US
Mailing Address - Phone:616-803-8400
Mailing Address - Fax:616-803-8500
Practice Address - Street 1:2020 RAYBROOK ST SE STE 102-3
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7717
Practice Address - Country:US
Practice Address - Phone:616-803-8400
Practice Address - Fax:616-803-8500
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010713251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical