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General NPI Number Information
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NPI Number | 1912346032
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Entity Type | Individual
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Provider Name | GREGORY LIPPERT MA, MHC, CSAC
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Gender | Male
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 250 NORTHWEST BLVD STE 110
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2971
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Country | US
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Telephone | 208-929-6845
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Fax |
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Provider Business Mailing Address
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Address Line | 9030 N HESS ST # 104
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City | HAYDEN
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State | ID
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Zip | 83835-9827
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Country | US
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Telephone | 808-852-9142
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Fax |
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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 | 300
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License Number State | HI
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