Provider Demographics
NPI:1447731872
Name:JENNIFER HIPPIE LCSW, LCAC
Entity type:Organization
Organization Name:JENNIFER HIPPIE LCSW, LCAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:HIPPIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCAC
Authorized Official - Phone:219-405-0250
Mailing Address - Street 1:523 W 100 N
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-9232
Mailing Address - Country:US
Mailing Address - Phone:219-405-0250
Mailing Address - Fax:219-464-8819
Practice Address - Street 1:5 WASHINGTON ST STE 250
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4769
Practice Address - Country:US
Practice Address - Phone:219-405-0250
Practice Address - Fax:219-464-8819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty