Provider Demographics
NPI:1700046125
Name:THOMAS S. LIPSITZ, PH.D., INC.
Entity Type:Organization
Organization Name:THOMAS S. LIPSITZ, PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:LIPSITZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:314-997-6463
Mailing Address - Street 1:777 CRAIG RD STE 120
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7133
Mailing Address - Country:US
Mailing Address - Phone:314-997-6463
Mailing Address - Fax:314-997-4423
Practice Address - Street 1:777 CRAIG RD STE 120
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7133
Practice Address - Country:US
Practice Address - Phone:314-997-6463
Practice Address - Fax:314-997-4423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00637103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000070029Medicare PIN