MEDICARE: CRISTINA TIPPET LCSW-C

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	1041C0700X	Clinical Social Worker	28852	MD

General Provider Information

NPI Number	:	1619519618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA TIPPET LCSW-C

Provider Business Mailing Address
First Line	:	1401 W 36TH ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-2305
Country	:	US
Telephone Number	:	443-720-0090
Fax Number	:	855-212-5690

Provider Business Practice Location Address
First Line	:	1401 W 36TH ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-2305
Country	:	US
Telephone Number	:	443-720-0090
Fax Number	:	855-212-5690

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

Provider Enumeration Date	:	10/10/2019
Last Update Date	:	02/03/2026

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