Provider Demographics
NPI:1528492972
Name:LIPARI, DOROTHEA MARIE (LICENSED SOCIAL WORK)
Entity type:Individual
Prefix:MS
First Name:DOROTHEA
Middle Name:MARIE
Last Name:LIPARI
Suffix:
Gender:F
Credentials:LICENSED SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:35 CROOKED HILL ROAD
Mailing Address - Street 2:SUITE #102
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725
Mailing Address - Country:US
Mailing Address - Phone:631-241-6981
Mailing Address - Fax:631-849-3300
Practice Address - Street 1:35 CROOKED HILL ROAD
Practice Address - Street 2:SUITE #102
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725
Practice Address - Country:US
Practice Address - Phone:631-241-6981
Practice Address - Fax:631-849-3300
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078314-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker