Provider Demographics
NPI:1154032027
Name:LIPSCOMB, SHELIA VANN (LCPC)
Entity type:Individual
Prefix:MRS
First Name:SHELIA
Middle Name:VANN
Last Name:LIPSCOMB
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 SAGE BRUSH CT
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-1059
Mailing Address - Country:US
Mailing Address - Phone:410-440-7430
Mailing Address - Fax:
Practice Address - Street 1:1622 SAGE BRUSH CT
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-1059
Practice Address - Country:US
Practice Address - Phone:410-440-7430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10115101YP2500X
MDLC13938101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional