Provider Demographics
NPI:1275364887
Name:LAWLESS, CHRISTINE (LSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LAWLESS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 RALEIGH CT E APT 26B
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-2659
Mailing Address - Country:US
Mailing Address - Phone:908-208-2351
Mailing Address - Fax:
Practice Address - Street 1:55 NEPTUNE BLVD
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4838
Practice Address - Country:US
Practice Address - Phone:732-776-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06663700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker