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General NPI Number Information
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NPI Number | 1497847628
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Entity Type | Individual
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Provider Name | EDNA M. PHIPPS LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 05/21/2010
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Provider Practice Location Address
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Address Line | 139 C BAKER STREET
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City | EMPORIA
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State | VA
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Zip | 23287
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Country | US
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Telephone | 804-221-0813
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Fax | 434-336-1516
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Provider Business Mailing Address
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Address Line | 6812 KILCHURN CT
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City | HENRICO
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State | VA
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Zip | 23231-7249
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Country | US
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Telephone | 804-221-0813
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Fax | 434-336-1516
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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 | 0904002630
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License Number State | VA
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