Individual provider · Type 1 NPI

Peter Dodge, LMSW

Addiction (Substance Use Disorder) Counselor · Ithaca, NY

NPI number 1003116351 Active

Practice location

334 W State St
Ithaca, NY 14850-5432

Fax (607) 273-1277

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed
Social Worker 104100000X077988 (NY)
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405XNone listed

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About NPI 1003116351

Peter Dodge, LMSW's National Provider Identifier is 1003116351, issued on Nov 2, 2010. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Ithaca, NY. The record was last updated on Nov 2, 2010.