Basic Information
| Provider Information | |||||||||
| NPI: | 1831724889 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LIPMAN | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LMHCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10716 STERLING APPLE DR | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462358201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173626801 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 601 LIBRARY PARK DR | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461421562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178819923 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2020 | ||||||||
| LastUpdateDate: | 03/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 88000835A | IN | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.