Healthcare Provider Details

I. General information

NPI: 1225944929
Provider Name (Legal Business Name): ISAAC LIPE LPCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S BROAD ST
CLINTON SC
29325-2507
US

IV. Provider business mailing address

778 POWER HOUSE RD
WARE SHOALS SC
29692-3846
US

V. Phone/Fax

Practice location:
  • Phone: 864-938-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11083
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: