Provider Demographics
NPI:1043637200
Name:DINNEEN, ELLEN G (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:G
Last Name:DINNEEN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 RIVEREDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-3110
Mailing Address - Country:US
Mailing Address - Phone:973-267-5080
Mailing Address - Fax:973-636-5640
Practice Address - Street 1:224 RIVEREDGE DR
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-3110
Practice Address - Country:US
Practice Address - Phone:973-267-5080
Practice Address - Fax:973-635-5640
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00043600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional