Provider Demographics
NPI:1972540839
Name:LIPPY, KAREN DOROTHY (RN MS CS-P MAC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:DOROTHY
Last Name:LIPPY
Suffix:
Gender:F
Credentials:RN MS CS-P MAC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:DOROTHY
Other - Last Name:FETHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2519 BIRD VIEW RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-8309
Mailing Address - Country:US
Mailing Address - Phone:410-840-8850
Mailing Address - Fax:
Practice Address - Street 1:40 S CHURCH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5414
Practice Address - Country:US
Practice Address - Phone:410-848-9244
Practice Address - Fax:410-876-5042
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO48443163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD217988OtherKAISER PERMANENTE
MD222912OtherMAMSI
MD224314OtherCOMPSYCH CORP.
MDPVPB2364OtherAMERICAN PSYCH SYSTEMS
MD001470OtherVALUE OPTIONS
MD528921-01OtherBLUE CROSS/BLUE SHIELD
MDPQ82OtherMAGELLAN BEHAVIORAL HEALT
MD001470OtherOPTIONS MENTAL HEALTH
MD5009458OtherAETNA HEALTH PLANS
MDPVPB 23640000OtherPREFERRED HEALTH NETWORK
MD222912OtherALLIANCE HEALTH PLAN
DCM074-0001OtherBLUE CROSS/BLUE SHIELD
MDPQ82OtherMAGELLAN BEHAVIORAL HEALT
MDS33466Medicare UPIN