Provider Demographics
NPI:1184962615
Name:TASIOPOULOS, CHRISULA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:CHRISULA
Middle Name:
Last Name:TASIOPOULOS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ORCHARD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2146
Mailing Address - Country:US
Mailing Address - Phone:862-209-7399
Mailing Address - Fax:862-772-7978
Practice Address - Street 1:21 ORCHARD ST FL 2
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:862-209-7399
Practice Address - Fax:862-772-7978
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053032001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical