Provider Demographics
NPI:1467040477
Name:PALLOTTA, CHRISTINA (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:PALLOTTA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:PALLOTTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:551 VALLEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1840
Mailing Address - Country:US
Mailing Address - Phone:347-233-0358
Mailing Address - Fax:
Practice Address - Street 1:551 VALLEY RD STE B
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1840
Practice Address - Country:US
Practice Address - Phone:347-233-0358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
44SC064370001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health