Provider Demographics
NPI:1528255072
Name:PATRICIA B. CRISTE PHD, LLC
Entity type:Organization
Organization Name:PATRICIA B. CRISTE PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:BEECH
Authorized Official - Last Name:CRISTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:978-851-5199
Mailing Address - Street 1:1565 MAIN ST
Mailing Address - Street 2:BUILDING 2 SUITE 200
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-2085
Mailing Address - Country:US
Mailing Address - Phone:987-851-5199
Mailing Address - Fax:978-851-5561
Practice Address - Street 1:1565 MAIN ST
Practice Address - Street 2:BUILDING 2 SUITE 200
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-2085
Practice Address - Country:US
Practice Address - Phone:987-851-5199
Practice Address - Fax:978-851-5561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1878101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty