Provider Demographics
NPI: | 1922186295 |
---|---|
Name: | LIPINSKI, VICTORIA (LCSW) |
Entity Type: | Individual |
Prefix: | |
First Name: | VICTORIA |
Middle Name: | |
Last Name: | LIPINSKI |
Suffix: | |
Gender: | F |
Credentials: | LCSW |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 10 CAIN DR |
Mailing Address - Street 2: | |
Mailing Address - City: | HILLSBOROUGH |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08844-2317 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 908-809-8113 |
Mailing Address - Fax: | 908-359-4616 |
Practice Address - Street 1: | 407 OMNI DR |
Practice Address - Street 2: | |
Practice Address - City: | HILLSBOROUGH |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08844-4527 |
Practice Address - Country: | US |
Practice Address - Phone: | 908-809-8113 |
Practice Address - Fax: | 908-359-5356 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-11-02 |
Last Update Date: | 2023-01-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 37LC00013900 | 101YA0400X |
NJ | 44SC04605300 | 1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
045713PSY | Medicare ID - Type Unspecified |