Provider Demographics
NPI:1083958508
Name:LIPKA, TRICIA L (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:L
Last Name:LIPKA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1071 PEMBERTON HILL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4268
Mailing Address - Country:US
Mailing Address - Phone:919-451-9281
Mailing Address - Fax:
Practice Address - Street 1:1071 PEMBERTON HILL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4268
Practice Address - Country:US
Practice Address - Phone:919-451-9281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0055681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical