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Organization

CHILD DEVELOPMENT INSTITUTE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEVI LIPOVENKO PSYD (CHAIRMAN OF THE BOARD)
(804) 446-1710
Entity
Organization

Contact information

Practice address
701 CROSS ST STE 237, LAKEWOOD, NJ 08701-4029
(848) 210-0028
Mailing address
701 CROSS ST STE 237, LAKEWOOD, NJ 08701-4029
(848) 210-0028

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TC0700X
Clinical Psychologist
Primary
104100000X
Social Worker
106H00000X
Marriage & Family Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1609352608
NJ
Enumeration date
09/21/2023
Last updated
12/25/2024
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