MEDICARE: LORI TIPPLE LPCC

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	101YP2500X	Professional Counselor	290229	KY

General Provider Information

NPI Number	:	1023602646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI TIPPLE LPCC

Provider Business Mailing Address
First Line	:	1105 JULIANNA CT STE 1
Second Line	:
City	:	ELIZABETHTOWN
State	:	KY
Zip	:	42701-7937
Country	:	US
Telephone Number	:	270-769-3714
Fax Number	:

Provider Business Practice Location Address
First Line	:	1105 JULIANNA CT STE 1
Second Line	:
City	:	ELIZABETHTOWN
State	:	KY
Zip	:	42701-7937
Country	:	US
Telephone Number	:	270-769-3714
Fax Number	:

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

Provider Enumeration Date	:	02/24/2021
Last Update Date	:	03/19/2024

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Directions to “ LORI TIPPLE LPCC” Practice Location

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