Provider Demographics
NPI:1558310235
Name:LIPZIN, ALAN M (LMHC)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:M
Last Name:LIPZIN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 W BUSCH BLVD
Mailing Address - Street 2:SUITE 603
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4523
Mailing Address - Country:US
Mailing Address - Phone:813-500-2449
Mailing Address - Fax:
Practice Address - Street 1:2901 W BUSCH BLVD
Practice Address - Street 2:SUITE 603
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4523
Practice Address - Country:US
Practice Address - Phone:813-500-2449
Practice Address - Fax:813-935-4797
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 1587101YM0800X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor