Basic Information
Provider Information | |||||||||
NPI: | 1124106430 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HIPOL LIGOT | ||||||||
FirstName: | CLARITA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | PH.D., LCADC, LMFT | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 183 S ORANGE AVE | ||||||||
Address2: |   | ||||||||
City: | NEWARK | ||||||||
State: | NJ | ||||||||
PostalCode: | 071032757 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9739725430 | ||||||||
FaxNumber: | 9739727173 | ||||||||
Practice Location | |||||||||
Address1: | 671 HOES LN | ||||||||
Address2: |   | ||||||||
City: | PISCATAWAY | ||||||||
State: | NJ | ||||||||
PostalCode: | 088545627 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8009695300 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/02/2006 | ||||||||
LastUpdateDate: | 02/03/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 02/03/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225C00000X | 37RC00203200 | NJ | N |   | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Counselor |   | 101YA0400X | 37LC00033600 | NJ | N |   | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | 37PC00002300 | NJ | N |   | Behavioral Health & Social Service Providers | Counselor | Professional | 106H00000X | 37FI00155800 | NJ | N |   | Behavioral Health & Social Service Providers | Marriage & Family Therapist |   | 103TC0700X | 35S100620000 | NJ | Y |   | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.