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General NPI Number Information
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NPI Number | 1073293783
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Entity Type | Organization
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Legal Business Name | LIP THERAPY AND COUNSELING
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 23550 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1447
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Country | US
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Telephone | 586-330-0672
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Fax |
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Provider Business Mailing Address
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Address Line | 14018 EDISON DR
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City | WARREN
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State | MI
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Zip | 48088-3702
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Country | US
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Telephone | 586-330-0672
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFF LIP
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Credential |
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Telephone | 586-330-0672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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