Provider Demographics
NPI:1700099355
Name:LIPPINCOTT, PRISCILLA D (LCPC)
Entity Type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:D
Last Name:LIPPINCOTT
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 1:600 WYNDHURST AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2415
Mailing Address - Country:US
Mailing Address - Phone:443-827-7497
Mailing Address - Fax:410-435-8010
Practice Address - Street 1:600 WYNDHURST AVE STE 305
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2415
Practice Address - Country:US
Practice Address - Phone:443-827-7497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3370101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD440084400Medicaid