Provider Demographics
NPI:1629701404
Name:SIVIK, CHRISTOPHER (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:SIVIK
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1905
Mailing Address - Country:US
Mailing Address - Phone:973-897-8364
Mailing Address - Fax:
Practice Address - Street 1:49 HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1905
Practice Address - Country:US
Practice Address - Phone:973-897-8364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00646900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health