Individual ProviderDanielle Jackson LippoldtBehavior AnalystBehavioral Health & Social Service ProvidersPractice Address2508 Mediterranean Ave, Virginia Beach, VA 23451-4032(757) 803-5663(757) 301-2411PECOS EnrollmentBased on the most recent information from CMS, provider Danielle Jackson Lippoldt 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 today at 11:48 AM.Profile DetailsProvider ID1720391022Provider TypeIndividualFull NameLippoldt, Danielle JacksonTitleMs.CredentialM.A.GenderFemaleSole ProprietorYesEnumeration Date7/15/2010Last Updated2/24/2025Contact InformationPractice LocationPractice Address2508 Mediterranean Ave, Virginia Beach, VA 23451-4032Phone(757) 803-5663Fax(757) 938-6944Mailing LocationMailing Address373 Edwin Dr, Virginia Beach, VA 23462-4522Phone(757) 301-2411Fax(888) 966-0621Provider TaxonomiesCodeDescriptionLicenseCode103K00000XPrimaryDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicense0133000608VirginiaCode235Z00000XDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense2202005994Virginia