Provider Demographics
NPI:1811686868
Name:LIPTAK, ELISABETH ANNE (MA, LGPC)
Entity type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:ANNE
Last Name:LIPTAK
Suffix:
Gender:F
Credentials:MA, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 CONNECTICUT AVE NW APT 408
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5609
Mailing Address - Country:US
Mailing Address - Phone:202-669-0859
Mailing Address - Fax:
Practice Address - Street 1:5039 CONNECTICUT AVE NW STE 7
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2056
Practice Address - Country:US
Practice Address - Phone:202-660-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC20001487101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health