Provider Demographics
NPI:1558342253
Name:LIPPENS, CRAIG HOWARD (CAC-AD)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:HOWARD
Last Name:LIPPENS
Suffix:
Gender:M
Credentials:CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 LAMPORT RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1409
Mailing Address - Country:US
Mailing Address - Phone:410-382-0528
Mailing Address - Fax:
Practice Address - Street 1:6207 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-1942
Practice Address - Country:US
Practice Address - Phone:443-835-2681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC1122101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)