Healthcare Provider Details

I. General information

NPI: 1083772800
Provider Name (Legal Business Name): FLASH PHIPPS LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23030 STATE ROUTE 73
W PORTSMOUTH OH
45663-8861
US

IV. Provider business mailing address

941 MARKET ST
PIKETON OH
45661-9757
US

V. Phone/Fax

Practice location:
  • Phone: 408-581-0637
  • Fax: 740-858-9140
Mailing address:
  • Phone: 740-289-2371
  • Fax: 740-289-4291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE0003607
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number262495
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: