Individual
MRS. CHRISTINE TERESA LOPEZ-PERGOLESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
21 OLD ROUTE 6, CARMEL, NY 10512-2107
(914) 257-3500
Mailing address
4 MARLBORO RD, NEW FAIRFIELD, CT 06812-3810
(034) 822-4252
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9568
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03008124
—
NY
Enumeration date
07/12/2010
Last updated
04/17/2023
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