Provider Demographics
NPI:1912086349
Name:LIPTON, EPHRAT LESS (ACSW, LCSW, BCD)
Entity Type:Individual
Prefix:MRS
First Name:EPHRAT
Middle Name:LESS
Last Name:LIPTON
Suffix:
Gender:F
Credentials:ACSW, LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 PARKLAND RUN SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-4733
Mailing Address - Country:US
Mailing Address - Phone:770-436-8684
Mailing Address - Fax:
Practice Address - Street 1:4015 S COBB DR SE
Practice Address - Street 2:SUITE 250
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6303
Practice Address - Country:US
Practice Address - Phone:404-202-0932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0027471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical