Whalio Doctors

NPI 1003116351

Peter Dodge, LMSW

Practitioner Addiction (Substance Use Disorder) Counselor Ithaca, NY

Practice location

Address
334 W State St, Ithaca, NY 14850-5432
Phone
(607) 273-5500
Fax
(607) 273-1277
Mailing address
334 W State St PO Box 789, Ithaca, NY 14850-5432

Registered specialties (3)

Addiction (Substance Use Disorder) Counselor Primary
Behavioral Health & Social Service Providers Taxonomy 101YA0400X
Social Worker
Behavioral Health & Social Service Providers Taxonomy 104100000X Licence 077988 (NY)
Substance Use Disorder Rehabilitation Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261QR0405X

Registry record

NPI
1003116351
Entity type
Individual
Sex (as registered)
Male
NPI issued
2 Nov 2010
Record last updated
2 Nov 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.