MEDICARE: ELIZABETH ANN LIPPITT LISW LICDC

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	1041C0700X	Clinical Social Worker	I-0008955	OH

General Provider Information

NPI Number	:	1174596407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANN LIPPITT LISW LICDC

Provider Business Mailing Address
First Line	:	4384 INNES AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45223-1710
Country	:	US
Telephone Number	:	513-542-1577
Fax Number	:	513-542-0616

Provider Business Practice Location Address
First Line	:	4039 HAMILTON AVE
Second Line	:	SUITE 309
City	:	CINCINNATI
State	:	OH
Zip	:	45223-2601
Country	:	US
Telephone Number	:	513-505-2446
Fax Number	:	513-542-0616

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	07/08/2007

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