Provider Demographics
NPI:1689722712
Name:GRAPA, CRISTINE (LCSW, LMFT, DCSW)
Entity Type:Individual
Prefix:
First Name:CRISTINE
Middle Name:
Last Name:GRAPA
Suffix:
Gender:F
Credentials:LCSW, LMFT, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 N 3RD AVE
Mailing Address - Street 2:SUITE 203A
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2429
Mailing Address - Country:US
Mailing Address - Phone:732-249-1457
Mailing Address - Fax:732-249-1902
Practice Address - Street 1:24 N 3RD AVE
Practice Address - Street 2:SUITE 203A
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2429
Practice Address - Country:US
Practice Address - Phone:732-249-1457
Practice Address - Fax:732-249-1902
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YM0800X
NJ44SC007517001041C0700X
NJ37FI00115900106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC00751700OtherNJ LICENSE # RE. LCSW
NJ37FI00115900OtherNJ LICENSE # RE. LMFT
NJGR700644Medicare UPIN
GR700644Medicare ID - Type Unspecified