Provider Demographics
NPI:1013340579
Name:LIPSCOMB, LASHAUNNA M (PHD, LCPC)
Entity Type:Individual
Prefix:DR
First Name:LASHAUNNA
Middle Name:M
Last Name:LIPSCOMB
Suffix:
Gender:F
Credentials:PHD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2911
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-0911
Mailing Address - Country:US
Mailing Address - Phone:518-331-0825
Mailing Address - Fax:
Practice Address - Street 1:2605 LORD BALTIMORE DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2652
Practice Address - Country:US
Practice Address - Phone:518-331-0825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3308101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health