Provider Demographics
NPI:1578385134
Name:ZIPIN, JESSICA MARTINE (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARTINE
Last Name:ZIPIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7006 BOYER ST
Mailing Address - Street 2:APT 1
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119
Mailing Address - Country:US
Mailing Address - Phone:301-801-9059
Mailing Address - Fax:
Practice Address - Street 1:1626 LOCUST ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6305
Practice Address - Country:US
Practice Address - Phone:301-801-9059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0249881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical