Active NPI
Lisa Calabrese Dodgen, MA
- Addiction (Substance Use Disorder) Counselor
- Boonton, NJ
National Provider Identifier
1700112562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 130 Powerville Rd
Boonton, NJ 07005-8705 - Phone
- (973) 316-1894
- Fax
- (973) 316-1829
- NPI assigned
- Oct 28, 2009
- Last updated
- Oct 28, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
130 Powerville Rd
Boonton, NJ 07005-8705
Mailing address
130 Powerville Rd
Boonton, NJ 07005-8705
Phone (973) 316-1894
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4138601 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256688000000",
"number": "1700112562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 POWERVILLE RD",
"city": "BOONTON",
"state": "NJ",
"postal_code": "070058705",
"telephone_number": "973-316-1894",
"fax_number": "973-316-1829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 POWERVILLE RD",
"city": "BOONTON",
"state": "NJ",
"postal_code": "070058705",
"telephone_number": "973-316-1894",
"fax_number": "973-316-1829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODGEN",
"first_name": "LISA",
"middle_name": "CALABRESE",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-28",
"last_updated": "2009-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4138601",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boonton, NJ
- Developmental Disability Awareness With Love (Ddawl)
- Developmental Disability Awareness With Love (Ddawl)
- Jonathan Martin Diaz
- Robert Joseph Dibenedetto, MD
- Kasey C Divine, CNM
- Joseph Ryan Donofrio
- Scott Charles Doughty, CADC
- Drug Fair Group, Inc. (Drug Fair of Boonton 54)
- Stacy Lynn Dutka
- Echo Blue Enterprise LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.