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General NPI Number Information
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NPI Number | 1265673305
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Entity Type | Individual
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Provider Name | PATTI P SHIPP LPC, MAC
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Gender | Female
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Dates
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Enumeration Date | 03/19/2009
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 46 WALL STREET WAY UNIT 2
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City | TOCCOA
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State | GA
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Zip | 30577-6236
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Country | US
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Telephone | 770-990-3754
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Fax |
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Provider Business Mailing Address
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Address Line | 101 CAMP RD
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City | EASTANOLLEE
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State | GA
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Zip | 30538-3085
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Country | US
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Telephone | 709-903-7547
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC004304
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License Number State | GA
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