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General NPI Number Information
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NPI Number | 1588112262
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Entity Type | Individual
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Provider Name | CHRISTIE CARRERA LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/12/2016
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 155 WILLOWBROOK BLVD STE 1103721
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City | WAYNE
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State | NJ
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Zip | 07470-7032
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Country | US
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Telephone | 732-292-5711
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Fax |
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Provider Business Mailing Address
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Address Line | 242 LAUREL CT
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City | WHITEHOUSE STATION
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State | NJ
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Zip | 08889-2025
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Country | US
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Telephone | 609-529-4940
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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 | 44SL06174900
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License Number State | NJ
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