Individual
BLAINE LIPFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., LPC
Contact information
Practice address
1405 RUCKER BLVD, ENTERPRISE, AL 36330-2236
(334) 417-0212
Mailing address
1405 RUCKER BLVD, ENTERPRISE, AL 36330-2236
(334) 417-0212
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279466
—
AL
Enumeration date
01/08/2018
Last updated
01/23/2024
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