Healthcare Provider Details

I. General information

NPI: 1447426242
Provider Name (Legal Business Name): DEBBIE LIPSHUTZ MSS, LSW, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BALA AVENUE SUITE 110
BALA CYNWYD PA
19004-3201
US

IV. Provider business mailing address

6117 MCCALLUM ST
PHILADELPHIA PA
19144-2603
US

V. Phone/Fax

Practice location:
  • Phone: 215-432-4339
  • Fax: 215-754-4339
Mailing address:
  • Phone: 215-432-4339
  • Fax: 215-754-4339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE S LIPSHUTZ
Title or Position: PRESIDENT
Credential: LCSW
Phone: 215-432-4339