1447426242 NPI number — DEBBIE LIPSHUTZ MSS, LSW, PC

Table of content: (NPI 1447426242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447426242 NPI number — DEBBIE LIPSHUTZ MSS, LSW, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEBBIE LIPSHUTZ MSS, LSW, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447426242
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6117 MCCALLUM ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19144-2603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-432-4339
Provider Business Mailing Address Fax Number:
215-754-4339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 BALA AVENUE
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
BALA CYNWYD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19004-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-432-4339
Provider Business Practice Location Address Fax Number:
215-754-4339
Provider Enumeration Date:
05/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
LIPSHUTZ
Authorized Official First Name:
DEBBIE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
215-432-4339

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1568497089 . This is a "INDIVIDUAL NPI (TYPE 1)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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