Provider Demographics
NPI:1629288337
Name:LIPMAN, DEBRA (LPHA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:LIPMAN
Suffix:
Gender:F
Credentials:LPHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3088 HILLBROOK LN
Mailing Address - Street 2:APT 204
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-7143
Mailing Address - Country:US
Mailing Address - Phone:630-728-5486
Mailing Address - Fax:
Practice Address - Street 1:3088 HILLBROOK LN
Practice Address - Street 2:APT 204
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-7143
Practice Address - Country:US
Practice Address - Phone:630-728-5486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007457101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health