| Organization Name: | LIPP, CARLSON, WITUCKI & ASSOCIATES, LTD |
| NPI Number: | 1043316961 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PRISCILLA MARTO (OFFICE MANAGER) |
| Mailing Address: | 2808 17th Ave S Grand Forks |
| State: | ND US |
| Postal Code: | 582014010 |
| Phone Number: | 7017468376 |
| Fax Number: | 7017469872 |
| NPI Enumeration Date: | 09/16/2006 |
| NPI Last Update Date: | 07/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |