Provider Demographics
NPI:1659502094
Name:PILIPIS, LOIS ANN (PHD, HSPP)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:ANN
Last Name:PILIPIS
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:ANN
Other - Last Name:EATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, HSPP
Mailing Address - Street 1:152 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-2619
Mailing Address - Country:US
Mailing Address - Phone:317-572-1313
Mailing Address - Fax:317-572-9999
Practice Address - Street 1:152 S 9TH ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2619
Practice Address - Country:US
Practice Address - Phone:317-572-1313
Practice Address - Fax:317-572-9999
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042584A103T00000X, 103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201158380AMedicaid