Provider Demographics
NPI:1922790989
Name:LIPPERT, BROOKE ASHLEY (CRC, LPC)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ASHLEY
Last Name:LIPPERT
Suffix:
Gender:F
Credentials:CRC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15045 LOXLEY LN
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48906-8315
Mailing Address - Country:US
Mailing Address - Phone:517-402-4877
Mailing Address - Fax:
Practice Address - Street 1:15045 LOXLEY LN
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-8315
Practice Address - Country:US
Practice Address - Phone:517-402-4877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional