Healthcare Provider Details

I. General information

NPI: 1164260030
Provider Name (Legal Business Name): CHRISTINA P HARRITY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2024
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 GROVE AVE
METUCHEN NJ
08840-1199
US

IV. Provider business mailing address

20 CANTERBURY LN
COLONIA NJ
07067-3002
US

V. Phone/Fax

Practice location:
  • Phone: 732-321-8744
  • Fax:
Mailing address:
  • Phone: 848-250-4922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05714700
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: