Provider Demographics
NPI:1558863621
Name:DEMARIA, CHRISTINA (ATR, LCAT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DEMARIA
Suffix:
Gender:F
Credentials:ATR, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 FOXHURST RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2301
Mailing Address - Country:US
Mailing Address - Phone:914-643-7348
Mailing Address - Fax:
Practice Address - Street 1:184 FOXHURST RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2301
Practice Address - Country:US
Practice Address - Phone:914-643-7348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000913101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health