Provider Demographics
NPI:1801978390
Name:LIPKIN, SUSAN MARLENE (LISW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARLENE
Last Name:LIPKIN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3452 LYNNFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4835
Mailing Address - Country:US
Mailing Address - Phone:216-314-6220
Mailing Address - Fax:216-831-2726
Practice Address - Street 1:24800 HIGHPOINT RD
Practice Address - Street 2:PSYCHOLOGICAL AND BEHAVIORAL CONSULTANTS
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-831-6611
Practice Address - Fax:216-831-2726
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-85211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical