Healthcare Provider Details

I. General information

NPI: 1346983582
Provider Name (Legal Business Name): DR MINDY BETH LIPSON PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9223 W KINGS AVE
PEORIA AZ
85382-3556
US

IV. Provider business mailing address

9223 W KINGS AVE
PEORIA AZ
85382-3556
US

V. Phone/Fax

Practice location:
  • Phone: 480-369-1808
  • Fax:
Mailing address:
  • Phone: 646-361-5251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MINDY BETH LIPSON
Title or Position: OWNER/PSYCHOLOGIST
Credential:
Phone: 646-361-5251