Provider Demographics
NPI:1033326764
Name:LIPSITT, PAUL D (PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:LIPSITT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2002
Mailing Address - Country:US
Mailing Address - Phone:617-965-0107
Mailing Address - Fax:
Practice Address - Street 1:881 COMMONWEALTH AVE
Practice Address - Street 2:BU STUDENT HEALTH
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1390
Practice Address - Country:US
Practice Address - Phone:617-353-3569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA007103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical