Provider Demographics
NPI:1568790798
Name:MASTROMINAS, CHRISTIANA J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIANA
Middle Name:J
Last Name:MASTROMINAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:CHRISTIANA
Other - Middle Name:JO
Other - Last Name:WIEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 CONGRESS COURT
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951
Mailing Address - Country:US
Mailing Address - Phone:215-534-8332
Mailing Address - Fax:
Practice Address - Street 1:807 LAWN AVE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1549
Practice Address - Country:US
Practice Address - Phone:215-257-6551
Practice Address - Fax:215-257-4008
Is Sole Proprietor?:No
Enumeration Date:2009-11-30
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical