Provider Demographics
NPI:1699080440
Name:TRAVIESO, CRISTINA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:
Last Name:TRAVIESO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2005
Mailing Address - Country:US
Mailing Address - Phone:914-629-0396
Mailing Address - Fax:
Practice Address - Street 1:25 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WEST HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10604-2005
Practice Address - Country:US
Practice Address - Phone:914-629-0396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089345-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical