Provider Demographics
NPI:1801407531
Name:LIPE, LANA M (LCSW)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:M
Last Name:LIPE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:FAWN
Other - Middle Name:M
Other - Last Name:LIPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9465 COUNSELORS ROW STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3817
Mailing Address - Country:US
Mailing Address - Phone:808-862-6589
Mailing Address - Fax:
Practice Address - Street 1:9465 COUNSELORS ROW STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-3817
Practice Address - Country:US
Practice Address - Phone:808-862-6589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-14
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-45261041C0700X
IN34010641A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty