Individual provider Active NPI

Clyde Anthony Lipp, LCPC

  • Mental Health Counselor
  • Moline, IL
National Provider Identifier
1346325966
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180-003329 Issued in IL
Practice address
4101 John Deere Rd
Moline, IL 61265-6790
Phone
(309) 762-5433
Fax
(309) 762-4481
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180-003329 IL Primary

Addresses

Primary practice location

4101 John Deere Rd
Moline, IL 61265-6790

Mailing address

4101 John Deere Rd
Moline, IL 61265-6790
Phone (309) 762-5433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180-003329ILMDMental Health Counselor

Interoperability endpoints

  • Direct secure messaging: clyde.lipp.p1@direct.tpqc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1346325966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 JOHN DEERE RD",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656790",
            "telephone_number": "309-762-5433",
            "fax_number": "309-762-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 JOHN DEERE RD",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656790",
            "telephone_number": "309-762-5433",
            "fax_number": "309-762-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPP",
        "first_name": "CLYDE",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180-003329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.