Provider Demographics
NPI:1265482202
Name:LIPSON, DOREE (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:DOREE
Middle Name:
Last Name:LIPSON
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:DOREE
Other - Middle Name:
Other - Last Name:GROSSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:257 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1610
Mailing Address - Country:US
Mailing Address - Phone:845-532-6064
Mailing Address - Fax:
Practice Address - Street 1:257 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1610
Practice Address - Country:US
Practice Address - Phone:845-532-6064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0769941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P38560Medicare PIN
NYA300059841Medicare PIN