Provider Demographics
NPI:1396859401
Name:LIPKIN, EILEEN LINDA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:LINDA
Last Name:LIPKIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 N INTERSTATE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1196
Mailing Address - Country:US
Mailing Address - Phone:503-267-9001
Mailing Address - Fax:503-249-5508
Practice Address - Street 1:3550 N INTERSTATE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1043
Practice Address - Country:US
Practice Address - Phone:503-331-5258
Practice Address - Fax:503-249-5508
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL13491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical