Individual provider Active NPI

Carol M Lipsky, PSY.D

  • Clinical Psychologist
  • Wayne, PA
National Provider Identifier
1275611824
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSO08844L Issued in PA
Practice address
181 Valley Stream Circle
Wayne, PA 19087-5818
Phone
(610) 436-1611
Fax
(610) 436-1611
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSO08844L PA Primary

Addresses

Primary practice location

181 Valley Stream Circle
Wayne, PA 19087-5818

Mailing address

181 Valley Stream Circle
Wayne, PA 19087-5818
Phone (610) 436-1611

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
I20140915001073 PA Practitioner - Clinical Psychologist 9830318476 Practice locations: Chesterbrook, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

181 Valley Stream Cir
Chesterbrook, PA 19087-5818
Phone (610) 436-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSO08844LPAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1275611824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 VALLEY STREAM CIRCLE",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190875818",
            "telephone_number": "610-436-1611",
            "fax_number": "610-436-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 VALLEY STREAM CIRCLE",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190875818",
            "telephone_number": "610-436-1611",
            "fax_number": "610-436-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSKY",
        "first_name": "CAROL",
        "middle_name": "M",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PSO08844L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

Verify at the official NPI Registry.