Provider Demographics
NPI:1225077951
Name:CIPOLLA, CATHERINE A (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:CIPOLLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1452
Mailing Address - Street 2:
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-5452
Mailing Address - Country:US
Mailing Address - Phone:609-748-8992
Mailing Address - Fax:609-748-8991
Practice Address - Street 1:227 E JIMMIE LEEDS RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9548
Practice Address - Country:US
Practice Address - Phone:609-748-8992
Practice Address - Fax:609-748-8991
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046501001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ260297OtherMAGELLAN BEHAVIORAL HEALT
NJP2965927OtherOXFORD HEALTH PLAN
NJ0717593000OtherCORRECT AMERIHEALTH NUMBE
NJ1053938OtherMANAGED HEALTH NETWORK
NJ3106950OtherAETNA
NYN8V852OtherEMPIRE
NJ1053938OtherMANAGED HEALTH NETWORK