Provider Demographics
NPI:1861462848
Name:LIPPMANN, JULIE A (PSYD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:LIPPMANN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:COHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 635
Mailing Address - Street 2:
Mailing Address - City:BELLMAWR
Mailing Address - State:NJ
Mailing Address - Zip Code:08099-0635
Mailing Address - Country:US
Mailing Address - Phone:856-566-6706
Mailing Address - Fax:856-566-6108
Practice Address - Street 1:42 LAUREL RD E
Practice Address - Street 2:UDP #1100
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1354
Practice Address - Country:US
Practice Address - Phone:856-566-7036
Practice Address - Fax:856-566-6108
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI00247500103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0244201Medicaid