Provider Demographics
NPI:1114169430
Name:CRISTINO, LORETTE A (MSW, LCSW, LCADC)
Entity type:Individual
Prefix:MS
First Name:LORETTE
Middle Name:A
Last Name:CRISTINO
Suffix:
Gender:
Credentials:MSW, LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 PEBBLE PL
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-2417
Mailing Address - Country:US
Mailing Address - Phone:732-673-9963
Mailing Address - Fax:
Practice Address - Street 1:65 JAMES STREET
Practice Address - Street 2:CENTER FOR BEHAVIORAL HEALTH
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08818
Practice Address - Country:US
Practice Address - Phone:732-321-7189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2025-02-18
Deactivation Date:2019-03-25
Deactivation Code:
Reactivation Date:2025-02-18
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00141400101YA0400X
NJ44SC055471001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)