Provider Demographics
NPI:1427238625
Name:LIPKA, STEPHANIE ANN
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:ANN
Last Name:LIPKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 S 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:TAFTVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06380-1311
Mailing Address - Country:US
Mailing Address - Phone:860-204-9346
Mailing Address - Fax:
Practice Address - Street 1:134 S 2ND AVE
Practice Address - Street 2:
Practice Address - City:TAFTVILLE
Practice Address - State:CT
Practice Address - Zip Code:06380-1311
Practice Address - Country:US
Practice Address - Phone:860-204-9346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health