NPIMap

Organization Active NPI

Equilibria Psychological and Consultation Services, LLC

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1356454045
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS015446 Issued in PA
Legal business name
EQUILIBRIA PSYCHOLOGICAL AND CONSULTATION SERVICES, LLC
Practice address
525 S 4TH St
Suite 471
Philadelphia, PA 19147-1570
Phone
(267) 861-3685
Fax
(215) 965-1513
NPI assigned
Aug 16, 2006
Last updated
Jun 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Authorized official

Name
Dr. Nicole Alexandra Lipkin, PSY.D., M.B.A.NPI 1932310356
Title
Owner and Executive Director
Phone
(267) 861-3685

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS015446 PA Primary
Forensic Psychologist 103TF0200X PS015446 PA

Addresses

Primary practice location

525 S 4TH St
Suite 471
Philadelphia, PA 19147-1570

Mailing address

525 S 4TH St
Suite 471
Philadelphia, PA 19147-1570
Phone (267) 861-3685

National Provider Directory

National Provider Directory

Locations

1516 N 5th St
Unit 401
Philadelphia, PA 19122

525 S 4th St
Ste 471
Philadelphia, PA 19147
Phone (215) 861-3685

Practitioners & affiliated clinicians

Practitioners 93

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 93

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1356454045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S 4TH ST",
            "address_2": "SUITE 471",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471570",
            "telephone_number": "267-861-3685",
            "fax_number": "215-965-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S 4TH ST",
            "address_2": "SUITE 471",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471570",
            "telephone_number": "267-861-3685",
            "fax_number": "215-965-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUILIBRIA PSYCHOLOGICAL AND CONSULTATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "LIPKIN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OWNER AND EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "267-861-3685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., M.B.A."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS015446",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "PA",
            "license": "PS015446",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.