Provider Demographics
NPI:1306915368
Name:LIPSCOMB, LINDA D (MSW, CPP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:D
Last Name:LIPSCOMB
Suffix:
Gender:F
Credentials:MSW, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8040 BAY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1690
Mailing Address - Country:US
Mailing Address - Phone:317-842-2958
Mailing Address - Fax:317-466-1710
Practice Address - Street 1:6100 N KEYSTONE AVE
Practice Address - Street 2:SUITE 237
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2452
Practice Address - Country:US
Practice Address - Phone:317-466-1749
Practice Address - Fax:317-466-1710
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCPP # 705104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker