Provider Demographics
NPI:1295412666
Name:LIPPE, JANA CROUCH (MED, LPC)
Entity type:Individual
Prefix:MRS
First Name:JANA
Middle Name:CROUCH
Last Name:LIPPE
Suffix:
Gender:
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 OVERTON PLZ STE 440
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4435
Mailing Address - Country:US
Mailing Address - Phone:254-493-4085
Mailing Address - Fax:
Practice Address - Street 1:103 N STAR DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2082
Practice Address - Country:US
Practice Address - Phone:361-579-0515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88451101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional