Provider Demographics
NPI:1013932417
Name:LIPTON, MERRIE D (LMFT)
Entity Type:Individual
Prefix:
First Name:MERRIE
Middle Name:D
Last Name:LIPTON
Suffix:
Gender:F
Credentials:LMFT
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 710
Mailing Address - Street 2:
Mailing Address - City:LOS OLIVOS
Mailing Address - State:CA
Mailing Address - Zip Code:93441-0710
Mailing Address - Country:US
Mailing Address - Phone:805-925-2555
Mailing Address - Fax:888-281-7061
Practice Address - Street 1:900 E MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5300
Practice Address - Country:US
Practice Address - Phone:805-925-2555
Practice Address - Fax:888-281-7061
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18436106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist