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General NPI Number Information
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NPI Number | 1659910750
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Entity Type | Individual
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Provider Name | DOROTHY CHIPPENDALE LMFT, LCADC
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Gender | Female
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Dates
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Enumeration Date | 01/06/2020
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 501 PROSPECT ST BLDG 1A
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5026
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Country | US
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Telephone | 732-961-9666
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Fax | 732-961-1125
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Provider Business Mailing Address
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Address Line | 57 ELM PL
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City | RED BANK
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State | NJ
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Zip | 07701-1916
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Country | US
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Telephone | 732-670-8228
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Fax | 732-961-1125
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37LC00185700
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License Number State | NJ
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