Provider Demographics
NPI:1467691634
Name:LIPCHIK, DEBRA ANNE (MFT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANNE
Last Name:LIPCHIK
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 SAWTELLE BLVD
Mailing Address - Street 2:355
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7014
Mailing Address - Country:US
Mailing Address - Phone:310-231-0356
Mailing Address - Fax:
Practice Address - Street 1:1950 SAWTELLE BLVD
Practice Address - Street 2:355
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7014
Practice Address - Country:US
Practice Address - Phone:310-231-0356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC19581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health