Provider Demographics
NPI:1700936648
Name:RIPPERTON, LISA ANNE (LCSW, LCAS)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANNE
Last Name:RIPPERTON
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ANNE
Other - Last Name:POIRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1233 EDGEWATER ST NW STE B
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-4049
Mailing Address - Country:US
Mailing Address - Phone:503-378-7526
Mailing Address - Fax:503-480-1611
Practice Address - Street 1:1233 EDGEWATER ST NW STE B
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-4049
Practice Address - Country:US
Practice Address - Phone:503-378-7526
Practice Address - Fax:503-480-1611
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL167591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical