Healthcare Provider Details

I. General information

NPI: 1689587503
Provider Name (Legal Business Name): CHRISTINE DANIEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 COMMERCE DR STE 210
CRANFORD NJ
07016-3621
US

IV. Provider business mailing address

88 MARION AVE
NEW PROVIDENCE NJ
07974-1908
US

V. Phone/Fax

Practice location:
  • Phone: 908-905-3444
  • Fax:
Mailing address:
  • Phone: 908-723-8135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: