Healthcare Provider Details

I. General information

NPI: 1184905960
Provider Name (Legal Business Name): CHRISTINE ANN FRANKOVIC LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2011
Last Update Date: 10/22/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FOREST AVE # A
PARAMUS NJ
07652-5429
US

IV. Provider business mailing address

610 VALLEY HEALTH PLZ
PARAMUS NJ
07652-3607
US

V. Phone/Fax

Practice location:
  • Phone: 201-490-5158
  • Fax:
Mailing address:
  • Phone: 201-265-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00359400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: