Provider Demographics
NPI:1659634228
Name:TIPPETT, DAWN (MSW, LCSW-C, CT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:TIPPETT
Suffix:
Gender:F
Credentials:MSW, LCSW-C, CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5537 TWIN KNOLLS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3270
Mailing Address - Country:US
Mailing Address - Phone:410-730-5072
Mailing Address - Fax:
Practice Address - Street 1:5537 TWIN KNOLLS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3270
Practice Address - Country:US
Practice Address - Phone:410-730-5072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD069901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical