Provider Demographics
NPI:1942459508
Name:PASSARELLA, CHRISTINA V (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:V
Last Name:PASSARELLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:CHRISTINA
Other - Middle Name:V
Other - Last Name:VAN RENSSELAER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:267 SKIPPERENE ROAD
Mailing Address - Street 2:
Mailing Address - City:NARROWSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12764
Mailing Address - Country:US
Mailing Address - Phone:845-252-3551
Mailing Address - Fax:
Practice Address - Street 1:20 COMMUNITY LN
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-2851
Practice Address - Country:US
Practice Address - Phone:845-292-8770
Practice Address - Fax:845-292-4298
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
071712-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical