Provider Demographics
NPI:1679609564
Name:REYNOLDS, CHRISTINE DEANS (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:DEANS
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:340 HAVEN AVE APT 2P
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-5337
Mailing Address - Country:US
Mailing Address - Phone:917-679-5180
Mailing Address - Fax:212-397-5044
Practice Address - Street 1:211 W 56TH ST
Practice Address - Street 2:SUITE 21J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4312
Practice Address - Country:US
Practice Address - Phone:917-679-5180
Practice Address - Fax:212-397-5044
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
NYR059606-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical