Individual
DOROTHY CHIPPENDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT, LCADC
Contact information
Practice address
501 PROSPECT ST BLDG 1A, LAKEWOOD, NJ 08701-5026
(732) 961-9666
(732) 961-1125
Mailing address
57 ELM PL, RED BANK, NJ 07701-1916
(732) 670-8228
(732) 961-1125
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
37LC00185700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37LC00185700
LICENSE NUMBER
NJ
Enumeration date
01/06/2020
Last updated
01/08/2020
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