Provider Demographics
NPI:1750594594
Name:SHIPMAN, DENNIS EARL (MSW, LCSW, LADC)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:EARL
Last Name:SHIPMAN
Suffix:
Gender:M
Credentials:MSW, LCSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-2910
Mailing Address - Country:US
Mailing Address - Phone:860-680-5918
Mailing Address - Fax:860-527-1919
Practice Address - Street 1:896 ASYLUM AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1901
Practice Address - Country:US
Practice Address - Phone:860-680-5918
Practice Address - Fax:860-527-1919
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CT81601041C0700X
CT830101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)