Provider Demographics
NPI:1568648863
Name:TIPELIN, MARSHA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:
Last Name:TIPELIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 DEBORAH DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2239
Mailing Address - Country:US
Mailing Address - Phone:732-549-1218
Mailing Address - Fax:732-549-0269
Practice Address - Street 1:21 DEBORAH DR
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2239
Practice Address - Country:US
Practice Address - Phone:732-549-1218
Practice Address - Fax:732-549-0269
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029206-1101YM0800X
NJ44SC01309100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health