Provider Demographics
NPI:1164797288
Name:LIPSEY, ELIZABETH ANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:LIPSEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW/LCSW
Mailing Address - Street 1:655 7TH ST BLDG 700A78
Mailing Address - Street 2:
Mailing Address - City:ROBINS AFB
Mailing Address - State:GA
Mailing Address - Zip Code:31098-2227
Mailing Address - Country:US
Mailing Address - Phone:478-319-6023
Mailing Address - Fax:
Practice Address - Street 1:655 7TH ST BLDG 700A78
Practice Address - Street 2:
Practice Address - City:ROBINS AFB
Practice Address - State:GA
Practice Address - Zip Code:31098-2227
Practice Address - Country:US
Practice Address - Phone:478-319-6023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0059761041C0700X
MSC56921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02032729Medicaid