Healthcare Provider Details

I. General information

NPI: 1538023817
Provider Name (Legal Business Name): AMY NOEL TIPPETT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7280 NW 87TH TER STE C-210
KANSAS CITY MO
64153-3720
US

IV. Provider business mailing address

1 BURNING BUSH CT
TROY MO
63379-3368
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax: 929-596-7897
Mailing address:
  • Phone: 636-236-2086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2014013098
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: