Doctor Name: | STEPHEN CRAIG LIPPOLD |
NPI Number: | 1174518781 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 23556 |
Business Practice Address: | 1560 W Bay Area Blvd Suite 305 Friendswood, TX - 775462667 |
Business Phone Number: | 2812188181 |
Business Fax Number: | 2812187676 |
Mailing Address: | 1560 W Bay Area Blvd, Suite 305 FRIENDSWOOD |
State: | TX |
Postal Code: | 775462667 |
Phone Number: | 2812188181 |
Fax Number: | 2812187676 |
NPI Enumeration Date: | 09/20/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 23556 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |