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1730658113 NPI number — PATRICIA JEAN TIPPINS PSY.D.

NPI Number: 1730658113
Health Care Provider/Practitioner: PATRICIA JEAN TIPPINS PSY.D.

Information about “1730658113” NPI (PATRICIA JEAN TIPPINS PSY.D.) exists in 1730658113 in HTML format HTML  |  1730658113 in plain Text format TXT  |  1730658113 in PDF (Portable Document Format) PDF  |  1730658113 in an XML format XML  formats.

NPI Number : 1730658113 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1730658113",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TIPPINS",
    "FirstName": "PATRICIA",
    "MiddleName": "JEAN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PSY.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TIPPINS",
    "OtherFirstName": "PATRICIA",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "PSY.D.",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "4379 EXCURSION DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLORADO SPGS",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80911-3659",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "719-291-5189",
    "MailingAddressFaxNumber": "719-291-5189",
    "FirstLinePracticeLocationAddress": "4379 EXCURSION DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLORADO SPGS",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80911-3659",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "719-291-5189",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/15/2018",
    "LastUpdateDate": "03/10/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "2104",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TC0700X",
          "TaxonomyName": "Clinical Psychologist",
          "LicenseNumber": "5470",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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