Healthcare Provider Details

I. General information

NPI: 1598527798
Provider Name (Legal Business Name): LORREN TIPPING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4041 W SYLVANIA AVE STE 202
TOLEDO OH
43623-4464
US

IV. Provider business mailing address

4041 W SYLVANIA AVE STE 202
TOLEDO OH
43623-4464
US

V. Phone/Fax

Practice location:
  • Phone: 419-504-5624
  • Fax:
Mailing address:
  • Phone: 419-504-5624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2405709
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: