Provider Demographics
NPI:1871651844
Name:LIPKA, DEBORAH L (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:L
Last Name:LIPKA
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 NOBSCOT RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3339
Mailing Address - Country:US
Mailing Address - Phone:978-443-3043
Mailing Address - Fax:978-443-3043
Practice Address - Street 1:54 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8239
Practice Address - Country:US
Practice Address - Phone:978-443-3043
Practice Address - Fax:978-443-3043
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10230501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
7381198OtherAETNA
P06949OtherBCBS
P06949Medicare ID - Type Unspecified