Individual ProviderDouglas Owen LippPsychologistBehavioral Health & Social Service ProvidersPractice AddressRiverside Counseling Center, 44084 Riverside Parkway Suite 240, Leesburg, VA 20176(703) 724-0200(540) 338-7304PECOS EnrollmentBased on the most recent information from CMS, provider Douglas Owen Lipp does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1295800597Provider TypeIndividualFull NameLipp, Douglas OwenTitleDr.CredentialPHDGenderMaleSole ProprietorNoEnumeration Date11/21/2006Last Updated7/8/2007Contact InformationPractice LocationPractice AddressRiverside Counseling Center, 44084 Riverside Parkway Suite 240, Leesburg, VA 20176Phone(703) 724-0200Fax(703) 724-4093Mailing LocationMailing Address104 Peachtree Court, Hamilton, VA 20158Phone(540) 338-7304FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode103TC0700XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicense0810003425Virginia