Individual
MS. CHRISTINA ANNE DICARLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, LCADC
Contact information
Practice address
568 THE HIDEOUT, LAKE ARIEL, PA 18436-9784
(973) 479-2297
Mailing address
568 THE HIDEOUT, LAKE ARIEL, PA 18436-9784
(973) 479-2297
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00171800
NJ
101YM0800X
Mental Health Counselor
Primary
37PC00395100
NJ
106H00000X
Marriage & Family Therapist
37PC00395100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932338159
HORIZON BLUE CROSS BLUE SHIELD OF NJ
—
Enumeration date
07/09/2009
Last updated
08/01/2024
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