Provider Demographics
NPI:1184082539
Name:CHRISTOPHE, VLADIMIR (LCSW, LCADC)
Entity type:Individual
Prefix:MR
First Name:VLADIMIR
Middle Name:
Last Name:CHRISTOPHE
Suffix:
Gender:M
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 BURNT TAVERN RD
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1496
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1140 BURNT TAVERN RD
Practice Address - Street 2:SUITE 2C
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-1496
Practice Address - Country:US
Practice Address - Phone:201-746-5279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-31
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00231100101YA0400X
PACW0197631041C0700X
NJ44SC056316001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)