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NPI Code Detail

MEDICARE: CHRISTOPHER PAUL VALLECILLO LCSW, LCADC

MEDICARE: CHRISTOPHER PAUL VALLECILLO LCSW, LCADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker44SC06211300NJ

General Provider Information

NPI Number : 1518740083
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER PAUL VALLECILLO LCSW, LCADC
Provider Business Mailing Address
First Line : 16 WHITESVILLE RD STE A
Second Line :
City : TOMS RIVER
State : NJ
Zip : 08753-4105
Country : US
Telephone Number : 732-504-3527
Fax Number :
Provider Business Practice Location Address
First Line : 16 WHITESVILLE RD STE A
Second Line :
City : TOMS RIVER
State : NJ
Zip : 08753-4105
Country : US
Telephone Number : 732-504-3527
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2023
Last Update Date : 05/28/2025

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