Provider Demographics
NPI:1164061347
Name:LIPINSKI, DANA LYNETTE
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:LYNETTE
Last Name:LIPINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7729 KINGSLEY DR
Mailing Address - Street 2:
Mailing Address - City:ONSTED
Mailing Address - State:MI
Mailing Address - Zip Code:49265-9407
Mailing Address - Country:US
Mailing Address - Phone:517-270-5200
Mailing Address - Fax:
Practice Address - Street 1:7729 KINGSLEY DR
Practice Address - Street 2:
Practice Address - City:ONSTED
Practice Address - State:MI
Practice Address - Zip Code:49265-9407
Practice Address - Country:US
Practice Address - Phone:517-270-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-05
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker