Provider Demographics
NPI:1962635094
Name:ALONSO, CHRISTINA ANGELES (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:ANGELES
Last Name:ALONSO
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 1:140 E MAIN ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2844
Mailing Address - Country:US
Mailing Address - Phone:516-480-2757
Mailing Address - Fax:
Practice Address - Street 1:140 E MAIN ST
Practice Address - Street 2:SUITE 12
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2844
Practice Address - Country:US
Practice Address - Phone:516-480-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73 0748151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical