Healthcare Provider Details

I. General information

NPI: 1497056956
Provider Name (Legal Business Name): JESSICA PAIGE LIPPE M.A., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2010
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 WAYNE ST
MONTVALE NJ
07645-2533
US

IV. Provider business mailing address

26 WAYNE ST
MONTVALE NJ
07645-2533
US

V. Phone/Fax

Practice location:
  • Phone: 201-679-6125
  • Fax:
Mailing address:
  • Phone: 201-679-6125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number15BC00385900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: