Healthcare Provider Details

I. General information

NPI: 1437801628
Provider Name (Legal Business Name): CHRISTIN ZIPPERER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 E JACKSON ST STE A
THOMASVILLE GA
31792-5175
US

IV. Provider business mailing address

13 WIREGRASS CIR
MOULTRIE GA
31768-6800
US

V. Phone/Fax

Practice location:
  • Phone: 229-891-4315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC012305
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: