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General NPI Number Information
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NPI Number | 1477038958
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Entity Type | Individual
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Provider Name | CHRISTINA LOUISE VENDETTI LMSW, LICSW, LCSW,
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Gender | Female
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Dates
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Enumeration Date | 10/01/2018
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 7 WARREN ST
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City | ALBANY
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State | NY
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Zip | 12203-3611
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Country | US
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Telephone | 914-539-5613
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Fax |
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Provider Business Mailing Address
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Address Line | 7 WARREN ST
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City | ALBANY
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State | NY
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Zip | 12203-3611
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Country | US
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Telephone | 914-539-5613
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 081146-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW133993
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 117479-SW-LICSW
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50081319
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License Number State | DC
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