Provider Demographics
NPI:1922641224
Name:BARNES-LEE, CRISTINA (LCSW)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:BARNES-LEE
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 1:4 OVERMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2913
Mailing Address - Country:US
Mailing Address - Phone:201-303-7108
Mailing Address - Fax:
Practice Address - Street 1:470 CHAMBERLAIN AVE STE 11
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07522-1000
Practice Address - Country:US
Practice Address - Phone:201-303-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06238400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No104100000XBehavioral Health & Social Service ProvidersSocial Worker