Healthcare Provider Details

I. General information

NPI: 1871582528
Provider Name (Legal Business Name): SHAWN ELLEN LIPINSKI SC.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 N GEORGE MASON DR STE 170
ARLINGTON VA
22205-3633
US

IV. Provider business mailing address

3040 WILLIAMS DR STE 100
FAIRFAX VA
22031-4618
US

V. Phone/Fax

Practice location:
  • Phone: 703-894-3800
  • Fax: 703-528-0338
Mailing address:
  • Phone: 571-350-8400
  • Fax: 703-940-8697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number0139000040
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: