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NPI Code Detail

MEDICARE: KELLI LIPSEY LCSWA

MEDICARE:   KELLI  LIPSEY  LCSWA
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
11041C0700XClinical Social WorkerP015833NC

General Provider Information

NPI Number : 1306513361
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLI LIPSEY LCSWA
Provider Business Mailing Address
First Line : 125 REMOUNT RD STE C1
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-6459
Country : US
Telephone Number : 704-284-7244
Fax Number :
Provider Business Practice Location Address
First Line : 125 REMOUNT RD STE C1
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-6459
Country : US
Telephone Number : 704-284-7244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2021
Last Update Date : 08/26/2021

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Directions to “ KELLI LIPSEY LCSWA” Practice Location

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