Provider Demographics
NPI:1295885200
Name:PIPAK, GARY E (LCSW)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:E
Last Name:PIPAK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 ABBE PL
Mailing Address - Street 2:
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-1320
Mailing Address - Country:US
Mailing Address - Phone:724-468-8497
Mailing Address - Fax:724-468-8497
Practice Address - Street 1:337 HARVEY AVE
Practice Address - Street 2:FIVE POINTS PROFESSIONAL BUILDING
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1994
Practice Address - Country:US
Practice Address - Phone:724-832-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0128271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPI 804332OtherBLUE SHIELD PROVIDER #
PA07332924Medicaid
PA535901OtherVALUEOPTIONS PROVIDER #
PA0000804332Medicare ID - Type Unspecified