Provider Demographics
NPI:1811290158
Name:PERROTTO, CHRISTINE NICOLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:NICOLE
Last Name:PERROTTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:NICOLE
Other - Last Name:PERROTTO-KNOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2801 NEUSE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2838
Mailing Address - Country:US
Mailing Address - Phone:252-636-6007
Mailing Address - Fax:252-672-0009
Practice Address - Street 1:2801 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2838
Practice Address - Country:US
Practice Address - Phone:252-636-6007
Practice Address - Fax:252-672-0009
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082462-1104100000X
NCC0082081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker