Provider Demographics
NPI:1720552896
Name:ANDOLENA, CHRISTIE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:ANDOLENA
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 1:210 W FRONT ST STE 206A
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1155
Mailing Address - Country:US
Mailing Address - Phone:732-926-4777
Mailing Address - Fax:732-926-5588
Practice Address - Street 1:210 W FRONT ST STE 206A
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1155
Practice Address - Country:US
Practice Address - Phone:732-926-4777
Practice Address - Fax:732-926-5588
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058318001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical