Provider Demographics
NPI:1578000659
Name:CHRISTA DURKIN, LCSW, P.C.
Entity Type:Organization
Organization Name:CHRISTA DURKIN, LCSW, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-538-2977
Mailing Address - Street 1:148 JACQUES AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3028
Mailing Address - Country:US
Mailing Address - Phone:347-538-2977
Mailing Address - Fax:
Practice Address - Street 1:148 JACQUES AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3028
Practice Address - Country:US
Practice Address - Phone:347-538-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0733641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty