| Doctor Name: | MS. DIANA RAE LIPPENCOTT |
| NPI Number: | 1861516569 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LSW, LICDC |
| License Number: | 954183 |
| Business Practice Address: | 4429 Professional Pkwy Groveport, OH - 431259228 |
| Business Phone Number: | 6148362434 |
| Business Fax Number: | |
| Mailing Address: | 221 Glenkirk Dr, BLACKLICK |
| State: | OH |
| Postal Code: | 430049464 |
| Phone Number: | 6145752994 |
| Fax Number: | |
| NPI Enumeration Date: | 03/19/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 954183 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |