MEDICARE: MERRIE D LIPTON LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC18436	CA

General Provider Information

NPI Number	:	1013932417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERRIE D LIPTON LMFT

Provider Business Mailing Address
First Line	:	PO BOX 710
Second Line	:
City	:	LOS OLIVOS
State	:	CA
Zip	:	93441-0710
Country	:	US
Telephone Number	:	805-925-2555
Fax Number	:	888-281-7061

Provider Business Practice Location Address
First Line	:	900 E MAIN ST STE 102
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-5300
Country	:	US
Telephone Number	:	805-925-2555
Fax Number	:	888-281-7061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	04/15/2024

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