Individual
MS. DIANA RAE LIPPENCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LSW, LICDC
Contact information
Practice address
1468 BRICE RD STE A, REYNOLDSBURG, OH 43068-2489
(614) 397-0110
(614) 694-2004
Mailing address
221 GLENKIRK DR, BLACKLICK, OH 43004-9464
(614) 575-2994
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
954183
OH
104100000X
Social Worker
Primary
S0014954
OH
Other
Enumeration date
03/19/2007
Last updated
10/27/2025
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