Provider Demographics
NPI:1528671781
Name:LIPPEL, JENNIFER JOANNE (MA, LCMHCA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JOANNE
Last Name:LIPPEL
Suffix:
Gender:F
Credentials:MA, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 LONE POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-5029
Mailing Address - Country:US
Mailing Address - Phone:704-451-5784
Mailing Address - Fax:
Practice Address - Street 1:117 LONE POPLAR DR
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-5029
Practice Address - Country:US
Practice Address - Phone:704-451-5784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-27
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15998101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health