1477940963 NPI number — TERRI HIPPS MS, LPC-S

Table of content: TERRI HIPPS MS, LPC-S (NPI 1477940963)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477940963 NPI number — TERRI HIPPS MS, LPC-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HIPPS
Provider First Name:
TERRI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, LPC-S
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477940963
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 CLAY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KERRVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78028-4525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-460-6022
Provider Business Mailing Address Fax Number:
830-202-2032

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 CLAY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KERRVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78028-4525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-460-6022
Provider Business Practice Location Address Fax Number:
830-202-2032
Provider Enumeration Date:
04/22/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  19820 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1778185 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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