Provider Demographics
NPI:1841915873
Name:COLLETTI, KRISTINA (LPC, LMHC, NCC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:COLLETTI
Suffix:
Gender:F
Credentials:LPC, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FIVE GREENTREE CENTRE
Mailing Address - Street 2:525 ROUTE 73 NORTH, SUITE 104
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-0805
Mailing Address - Country:US
Mailing Address - Phone:848-272-1160
Mailing Address - Fax:
Practice Address - Street 1:FIVE GREENTREE CENTRE
Practice Address - Street 2:525 ROUTE 73 NORTH, SUITE 104
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-0805
Practice Address - Country:US
Practice Address - Phone:848-272-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012771-01101YM0800X
NJ37PC00548500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health