Provider Demographics
NPI:1841263688
Name:LIPPHARDT, NANCY T (LISW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:T
Last Name:LIPPHARDT
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 1:750 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1092
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 N EWING ST
Practice Address - Street 2:UNIT B
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3383
Practice Address - Country:US
Practice Address - Phone:740-689-6700
Practice Address - Fax:740-689-6702
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-0004739104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI 0004739OtherLICENSE
OH000000387060OtherANTHEM
OH000000387060OtherANTHEM