Provider Demographics
NPI:1801549985
Name:LIPINSKI, KRISTIN (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:LIPINSKI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 WOLF PIT RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2432
Mailing Address - Country:US
Mailing Address - Phone:860-335-2586
Mailing Address - Fax:
Practice Address - Street 1:270 GREENWICH AVE
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6530
Practice Address - Country:US
Practice Address - Phone:203-247-6362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-30
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5093104100000X
CT120421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker