Provider Demographics
NPI:1023144870
Name:CRITES, VIVIAN CELESTE (LCISW,LMFT,LCDC,SAP)
Entity type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:CELESTE
Last Name:CRITES
Suffix:
Gender:F
Credentials:LCISW,LMFT,LCDC,SAP
Other - Prefix:MR
Other - First Name:VIVIAN
Other - Middle Name:
Other - Last Name:CUBANO DE CRITES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCISW,LMFT,LCDC,SAP
Mailing Address - Street 1:9100 PORT OF SALE MALL
Mailing Address - Street 2:SUITE #15
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-3602
Mailing Address - Country:US
Mailing Address - Phone:340-777-9393
Mailing Address - Fax:340-775-3983
Practice Address - Street 1:4004 RHYMER HIGHWAY
Practice Address - Street 2:SUITE 2-5 DOCTOR'S PARK II
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-777-9363
Practice Address - Fax:340-775-3983
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1-2027479-2007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health