Provider Demographics
NPI:1821350679
Name:LIPETZKY, JENNIFER LYNN (LPCLPCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:LIPETZKY
Suffix:
Gender:F
Credentials:LPCLPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 2ND AVE NE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-3373
Mailing Address - Country:US
Mailing Address - Phone:701-952-7400
Mailing Address - Fax:701-952-7401
Practice Address - Street 1:300 2ND AVE NE
Practice Address - Street 2:SUITE 215
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-3373
Practice Address - Country:US
Practice Address - Phone:701-952-7400
Practice Address - Fax:701-952-7401
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND591-8-27-07-202101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional