Provider Demographics
NPI:1659330785
Name:DIPOTO, MARC CHRISTOPHER (LPC)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:CHRISTOPHER
Last Name:DIPOTO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 VICTORY DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-3807
Mailing Address - Country:US
Mailing Address - Phone:816-268-8501
Mailing Address - Fax:816-452-5700
Practice Address - Street 1:9 VICTORY DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3807
Practice Address - Country:US
Practice Address - Phone:816-268-8501
Practice Address - Fax:816-452-5700
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health