Provider Demographics
NPI:1437814209
Name:LIPPENCOTT, CAROL
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:LIPPENCOTT
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 1:2262 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:LEMONT FURNACE
Mailing Address - State:PA
Mailing Address - Zip Code:15456-1332
Mailing Address - Country:US
Mailing Address - Phone:724-323-8200
Mailing Address - Fax:
Practice Address - Street 1:3591 PITTSBURGH RD
Practice Address - Street 2:
Practice Address - City:PERRYOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15473-1307
Practice Address - Country:US
Practice Address - Phone:724-736-8390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)