Provider Demographics
NPI:1891383113
Name:IARUSSI, KRISTINE (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:
Last Name:IARUSSI
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:FANWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07023-1142
Mailing Address - Country:US
Mailing Address - Phone:908-477-5162
Mailing Address - Fax:
Practice Address - Street 1:395 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-1178
Practice Address - Country:US
Practice Address - Phone:908-363-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-03
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00687300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional