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General NPI Number Information
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NPI Number | 1235888728
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Entity Type | Organization
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Legal Business Name | TIPTON PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 2302 10TH AVE STE 4
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City | CANYON
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State | TX
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Zip | 79015-5200
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Country | US
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Telephone | 806-476-1440
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Fax | 806-476-1450
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Provider Business Mailing Address
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Address Line | 3308 LINDA LN
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City | CANYON
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State | TX
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Zip | 79015-4806
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Country | US
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Telephone | 304-534-1839
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK A TIPTON
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Credential | PSY. D
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Telephone | 304-534-1839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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