Provider Demographics
NPI:1104286160
Name:DESILVESTRI, CHRIS (LMFT LCADC)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:DESILVESTRI
Suffix:
Gender:M
Credentials:LMFT LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 LAURIE LN
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-1501
Mailing Address - Country:US
Mailing Address - Phone:732-309-6104
Mailing Address - Fax:
Practice Address - Street 1:506 LAURIE LN
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-1501
Practice Address - Country:US
Practice Address - Phone:732-309-6104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00176700101YA0400X
NJ37FI00176800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)