Provider Demographics
NPI:1679154322
Name:VANVLEET, CRISTEN (LCSW)
Entity Type:Individual
Prefix:
First Name:CRISTEN
Middle Name:
Last Name:VANVLEET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LINCOLN PL APT 5A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-5821
Mailing Address - Country:US
Mailing Address - Phone:512-560-4421
Mailing Address - Fax:
Practice Address - Street 1:400 LINCOLN PL APT 5A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5821
Practice Address - Country:US
Practice Address - Phone:512-560-4421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0857171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical