You can use "Get-Recipient" to get all mail-enabled objects (mail users, mailboxes, mail contacts, and distribution groups). Each will have an EmailAddresses property that is an array of all the email addresses assigned to that object.
You can use the email addresses in your CSV as the -Identity parameter value on the Get-Recipient cmdlet. If the email address from the CSV is present in the AD you'll have the answer as to whether or not it exists.
Determine the type of recipient that uses the email address and use the appropriate Set- cmdlet to add the new email address.