Provider Demographics
NPI:1851981773
Name:LIPINSKI, MEGAN KAYLA (BCBA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KAYLA
Last Name:LIPINSKI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24555 HALLWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-1667
Mailing Address - Country:US
Mailing Address - Phone:248-238-9772
Mailing Address - Fax:
Practice Address - Street 1:24555 HALLWOOD CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-1667
Practice Address - Country:US
Practice Address - Phone:248-238-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7401001341103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst