Doctor Name: | NICOLE PIPITONE |
NPI Number: | 1114336757 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 002536 |
Business Practice Address: | 2400 Tamarack Ave Ste 203 South Windsor, CT - 060745559 |
Business Phone Number: | 8605334672 |
Business Fax Number: | |
Mailing Address: | 2400 Tamarack Ave Ste 203, SOUTH WINDSOR |
State: | CT |
Postal Code: | 060745559 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/07/2014 |
NPI Last Update Date: | 08/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 002536 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |