Healthcare Provider Details

I. General information

NPI: 1316439821
Provider Name (Legal Business Name): KERI LIPFORD LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2018
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 MILL BRANCH RD
BELPRE OH
45714-8115
US

IV. Provider business mailing address

1658 MILL BRANCH RD
BELPRE OH
45714-8115
US

V. Phone/Fax

Practice location:
  • Phone: 681-350-1122
  • Fax: 681-350-1122
Mailing address:
  • Phone: 681-350-1122
  • Fax: 681-350-1122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberDP00945591
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2608496
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: