Provider Demographics
NPI:1750321550
Name:LIPPERT, FERN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:FERN
Middle Name:
Last Name:LIPPERT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23801 CALABASAS RD
Mailing Address - Street 2:1024
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1547
Mailing Address - Country:US
Mailing Address - Phone:818-591-8000
Mailing Address - Fax:818-591-8003
Practice Address - Street 1:23801 CALABASAS RD
Practice Address - Street 2:1024
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1547
Practice Address - Country:US
Practice Address - Phone:818-591-8000
Practice Address - Fax:818-591-8003
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22320101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health