Healthcare Provider Details

I. General information

NPI: 1619730165
Provider Name (Legal Business Name): PIPPI M. WINGFIELD MSW., LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 SOUTHLAND DR
CHESTER VA
23831-2354
US

IV. Provider business mailing address

8707 MCKIBBEN DR
CHESTERFIELD VA
23838-5530
US

V. Phone/Fax

Practice location:
  • Phone: 804-528-4331
  • Fax: 804-222-3232
Mailing address:
  • Phone: 804-350-5336
  • Fax: 804-222-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number270101043
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0904015990
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: