Healthcare Provider Details

I. General information

NPI: 1871486118
Provider Name (Legal Business Name): LISA M ZIPSER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 WEST SOUTH AIRPORT ROAD
TRAVERSE CITY MI
49684
US

IV. Provider business mailing address

6255 US HIGHWAY 31 N APT 204
WILLIAMSBURG MI
49690-9467
US

V. Phone/Fax

Practice location:
  • Phone: 231-590-3732
  • Fax:
Mailing address:
  • Phone: 231-360-0356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851111258
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: