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General NPI Number Information
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NPI Number | 1679641518
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Entity Type | Individual
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Provider Name | RODERICK D. LIPSCOMB CM
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | TRANSITIONAL ASSISTANCE SVC., 6100 N. KEYSTONE AVENUE SUITE 237
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-2426
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Country | US
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Telephone | 317-466-1740
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Fax | 317-466-1710
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Provider Business Mailing Address
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Address Line | 8040 BAY BROOK DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-1690
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Country | US
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Telephone | 317-842-5787
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Fax | 317-466-1710
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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