Basic Information
| Provider Information | |||||||||
| NPI: | 1891852711 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LIPPINCOTT | ||||||||
| FirstName: | SANDRA | ||||||||
| MiddleName: | JEANNE | ||||||||
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| Credential: | MA, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 E OLIVE ST | ||||||||
| Address2: | SEATTLE MENTAL HEALTH | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981222735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063022200 | ||||||||
| FaxNumber: | 2063022210 | ||||||||
| Practice Location | |||||||||
| Address1: | 4240 AUBURN WAY N | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980021311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538768900 | ||||||||
| FaxNumber: | 2538768910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2007 | ||||||||
| LastUpdateDate: | 03/26/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | LF00001326 | WA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101Y00000X | LF00001326 | WA | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | LF00001326 | WA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.