Healthcare Provider Details

I. General information

NPI: 1619640539
Provider Name (Legal Business Name): JAMIE LIPPINCOTT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10892 CRABAPPLE RD STE 202
ROSWELL GA
30075-5834
US

IV. Provider business mailing address

10892 CRABAPPLE RD STE 202
ROSWELL GA
30075-5834
US

V. Phone/Fax

Practice location:
  • Phone: 404-919-4028
  • Fax:
Mailing address:
  • Phone: 404-919-4028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: