Child Development Institute Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CHILD DEVELOPMENT INSTITUTE INC

Practice address

701 Cross St Ste 237
Lakewood, NJ 08701-4029

Phone

(848) 210-0028

NPI assigned

Sep 21, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Levi Lipovenko, PSYD

Title

Chairman of the Board

Phone

(804) 446-1710

Specialties & licenses 4

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735084800000",
    "number": "1124806997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 CROSS ST STE 237",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014029",
            "telephone_number": "848-210-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 CROSS ST STE 237",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014029",
            "telephone_number": "848-210-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD DEVELOPMENT INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-21",
        "last_updated": "2024-12-25",
        "certification_date": "2024-12-25",
        "status": "A",
        "authorized_official_last_name": "LIPOVENKO",
        "authorized_official_first_name": "LEVI",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "804-446-1710",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609352608",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.