Provider Demographics
NPI:1336597269
Name:VINPA, KRYSTINA (LCSW, LCADC)
Entity type:Individual
Prefix:
First Name:KRYSTINA
Middle Name:
Last Name:VINPA
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 COMMANDER BLACK DR
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1910
Mailing Address - Country:US
Mailing Address - Phone:551-265-2206
Mailing Address - Fax:
Practice Address - Street 1:117 COMMANDER BLACK DR
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1910
Practice Address - Country:US
Practice Address - Phone:551-265-2206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00234400101YA0400X
KY2581821041C0700X
NJ44SC057389001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)