Provider Demographics
NPI:1588111793
Name:LIPTON, ELIZABETH KAUFMAN
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KAUFMAN
Last Name:LIPTON
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 1:636 TEMPLE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-1248
Mailing Address - Country:US
Mailing Address - Phone:206-817-0023
Mailing Address - Fax:
Practice Address - Street 1:636 TEMPLE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90814-1248
Practice Address - Country:US
Practice Address - Phone:206-817-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0002245031041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000224503OtherTHE ASSOCIATION OF SOCIAL WORK BOARDS