MEDICARE: KATELYN A LIPP MA, LPC, LMFT, CAADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	6401014878	MI
2	106H00000X	Marriage & Family Therapist	4101006658	MI

General Provider Information

NPI Number	:	1134508872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN A LIPP MA, LPC, LMFT, CAADC

Provider Business Mailing Address
First Line	:	39209 6 MILE RD STE 211
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48152-3900
Country	:	US
Telephone Number	:	248-470-1102
Fax Number	:

Provider Business Practice Location Address
First Line	:	39209 6 MILE RD STE 211
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48152-3900
Country	:	US
Telephone Number	:	248-470-1102
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2015
Last Update Date	:	06/16/2026

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