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General NPI Number Information
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NPI Number | 1326068636
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Entity Type | Individual
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Provider Name | CHRISTINE VERDEEN VERCELLINO LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 03/05/2015
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Provider Practice Location Address
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Address Line | 16031 COMPRINT CIR
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City | GAITHERSBURG
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State | MD
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Zip | 20877-1320
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Country | US
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Telephone | 301-330-0377
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Fax |
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Provider Business Mailing Address
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Address Line | 3230 E WOODMEN RD SUITE 110
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-8501
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Country | US
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Telephone | 301-509-6053
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09923762
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License Number State | CO
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