MEDICARE: MS. MONIQUE LIPMAN LISW-S

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.2102829-SUPV	OH

General Provider Information

NPI Number	:	1811664675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONIQUE LIPMAN LISW-S

Provider Business Mailing Address
First Line	:	309 VINE ST APT 902
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-3654
Country	:	US
Telephone Number	:	415-254-0014
Fax Number	:

Provider Business Practice Location Address
First Line	:	309 VINE ST APT 902
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-3654
Country	:	US
Telephone Number	:	415-254-0014
Fax Number	:

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

Provider Enumeration Date	:	08/27/2021
Last Update Date	:	11/26/2025

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