Individual provider Active NPI

Brittany Nicole Lippert, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Danville, PA
National Provider Identifier
1003442369
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PS019632 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-9800
Phone
(570) 808-3100
NPI assigned
Mar 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Child & Adolescent Psychologist 103TC2200X PS019632 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-9800

Mailing address

8 Church St
Professional Building 4TH Floor Psychiatry
Wilkes-Barre, PA 18702

Other practice location 1

189 Market St
Kingston, PA 18704-5400
Phone (570) 961-3361

Other identifiers 1

IdentifierTypeStateIssuer
27642049OtherPADRIVERS NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912003793 PA Practitioner - Clinical Psychologist 1850776808 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS019632PAMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Aug 15, 2022 Accepting new patients
John G Kuna Psy D & Associates LLC PastSince Mar 2, 2020 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

8 Church St
Bldg 4TH
Wilkes Barre, PA 18702

25 Church St
Wilkes Barre, PA 18765
Phone (570) 826-3100

Interoperability endpoints

  • Direct secure messaging: blippert502226@direct.geisinger.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1003442369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CHURCH ST",
            "address_2": "PROFESSIONAL BUILDING 4TH FLOOR PSYCHIATRY",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "18702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-808-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "189 Market St",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "PA",
            "postal_code": "187045400",
            "country_code": "US",
            "telephone_number": "570-961-3361",
            "fax_number": "570-961-3364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIPPERT",
        "first_name": "BRITTANY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS019632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS NUMBER",
            "identifier": "27642049",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.