Healthcare Provider Details

I. General information

NPI: 1538467071
Provider Name (Legal Business Name): PIA P LIPSCOMB-KING MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PIA P LIPSCOMB MSW

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 05/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 44TH AVE
UNIVERSITY PARK MD
20782-2122
US

IV. Provider business mailing address

1425 UNIVERSITY BLVD E SUITE 245
HYATTSVILLE MD
20783-4618
US

V. Phone/Fax

Practice location:
  • Phone: 240-667-2354
  • Fax:
Mailing address:
  • Phone: 202-280-9954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG101145
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: