Peter Dodge, LMSW in Ithaca, NY - Counselor

Peter Dodge, LMSW is a Counselor - Addiction (substance Use Disorder) based in Ithaca, New York. Peter Dodge is licensed to practice in * (Not Available) (license number ) and his current practice location is 334 W State St, Ithaca, New York. He can be reached at his office (for appointments etc.) via phone at (607) 273-5500.

NPI number for Peter Dodge is 1003116351 and his current mailing address is 334 W State St, Po Box 789, Ithaca, New York. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1003116351.

Contact Information

	Peter Dodge, LMSW
	334 W State St, Ithaca, NY 14850-5432
	(607) 273-5500
	(607) 273-1277

Healthcare Provider's Profile

Full Name	Peter Dodge
Gender	Male
Speciality	Counselor - Addiction (substance Use Disorder)
Location	334 W State St, Ithaca, New York
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1003116351
Provider Enumeration Date: 11/02/2010
Last Update Date: 11/02/2010

Medical Identifiers

Medical identifiers for Peter Dodge such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003116351	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	(* (Not Available))	Primary
104100000X	Social Worker	077988 (New York)	Secondary
261QR0405X	Clinic/center - Rehabilitation, Substance Use Disorder	(New York)	Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Peter Dodge is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Peter Dodge, LMSW 334 W State St, Po Box 789, Ithaca, NY 14850-5432 Ph: (607) 273-5500	Peter Dodge, LMSW 334 W State St, Ithaca, NY 14850-5432 Ph: (607) 273-5500

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Stacy Cangelosi Mike, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Green St, Suite 500, Ithaca, NY 14850 Phone: 607-274-6288
Mr. Allen John Agnew, CASAC NYS 13121 Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Green St, Suite 500, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280
Vanessa Hendrickson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Green St Ste 500, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280
Mr. Colin Andrew Polnitsky, MSW INTERN Counselor Medicare: Medicare Enrolled Practice Location: 201 E Green St, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280

Peter Dodge, LMSW - Counselor in Ithaca, NY