Provider Demographics
NPI:1730442419
Name:VANZELLA, CHRISTINA (LCSW, PMH-C)
Entity type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:
Last Name:VANZELLA
Suffix:
Gender:F
Credentials:LCSW, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 STERLING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:TN
Mailing Address - Zip Code:38004-7918
Mailing Address - Country:US
Mailing Address - Phone:201-888-1469
Mailing Address - Fax:
Practice Address - Street 1:512 STERLING RIDGE DR
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:TN
Practice Address - Zip Code:38004-7918
Practice Address - Country:US
Practice Address - Phone:201-888-1469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040111801041C0700X
DCLC2000021681041C0700X
NJ44SC056769001041C0700X
TN94121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical