Provider Demographics
NPI:1457862914
Name:LIPSKEY, AUDREY ANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:ANNE
Last Name:LIPSKEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:AUDREY
Other - Middle Name:ANNE
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 NE NEFF RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6015
Mailing Address - Country:US
Mailing Address - Phone:541-706-6700
Mailing Address - Fax:
Practice Address - Street 1:916 SW 17TH ST STE 202
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2572
Practice Address - Country:US
Practice Address - Phone:541-706-2768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL72081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical