Provider Demographics
NPI:1356768477
Name:BAMBERY, CHRISTINE (LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BAMBERY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:BAMBERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:515 MADISON AVE
Mailing Address - Street 2:3300
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5403
Mailing Address - Country:US
Mailing Address - Phone:212-308-7380
Mailing Address - Fax:212-486-3437
Practice Address - Street 1:515 MADISON AVE
Practice Address - Street 2:3300
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5403
Practice Address - Country:US
Practice Address - Phone:212-308-7380
Practice Address - Fax:212-486-3437
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005989101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health