Provider Demographics
NPI:1639844822
Name:STRATIDIS-MACRINI, CHRISTINA MARIA (LMSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIA
Last Name:STRATIDIS-MACRINI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 BROAD ST STE A
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3261
Mailing Address - Country:US
Mailing Address - Phone:203-874-3749
Mailing Address - Fax:
Practice Address - Street 1:112 MONTICELLO DR
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4164
Practice Address - Country:US
Practice Address - Phone:203-988-5110
Practice Address - Fax:203-488-1983
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5595104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT5595OtherHUSKY, BLUECROSS BLUESHIELD