National Provider Identifier
Peter Dodge, LMSW
Peter Dodge, LMSW is listed in the NPPES registry with a primary specialty of Addiction (Substance Use Disorder) Counselor in Ithaca, NY and a listed phone number of (607) 273-5500.
Profile Overview
- NPI
- 1003116351
- Provider Type
- Individual
- Primary Specialty
- Addiction (Substance Use Disorder) Counselor
- Enumeration Date
- November 02, 2010
- Last Updated
- November 02, 2010
Practice Location
- 334 W State St
- Ithaca, NY 14850-5432
Phone: (607) 273-5500
Mailing Address
- 334 W State St
- PO Box 789
- Ithaca, NY 14850-5432
Specialties
- Addiction (Substance Use Disorder) Counselor (101YA0400X)
- Social Worker (104100000X)
- Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X)
Full Record
- NPI
- 1003116351
- Entity Type
- Individual
- Last Name
- Dodge
- First Name
- Peter
- Credential
- LMSW
- Mailing Street Address
- 334 W State St
- Mailing Address Line 2
- PO Box 789
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-5432
- Mailing Country
- US
- Mailing Phone
- (607) 273-5500
- Mailing Fax
- (607) 273-1277
- Practice Street Address
- 334 W State St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5432
- Practice Country
- US
- Practice Phone
- (607) 273-5500
- Practice Fax
- (607) 273-1277
- Enumeration Date
- November 02, 2010
- Last Updated
- November 02, 2010
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Addiction (Substance Use Disorder) Counselor (101YA0400X), Social Worker (104100000X), Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X)