Individual
DR. RANDOLPH SCOTT SHIPON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., NCC, LPC
Contact information
Practice address
550 W MAIN ST, BOONTON, NJ 07005-1168
(215) 906-3967
(973) 300-1443
Mailing address
5 DEER HILL CT, BOONTON, NJ 07005-1861
(215) 906-3967
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
018363
NY
103T00000X
Psychologist
Primary
35SI00473800
NJ
103T00000X
Psychologist
B1-0000832
DE
Other
Enumeration date
04/20/2009
Last updated
01/20/2010
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