Provider Demographics
NPI:1083772800
Name:PHIPPS, FLASH (LPCC)
Entity Type:Individual
Prefix:MR
First Name:FLASH
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PIKETON
Mailing Address - State:OH
Mailing Address - Zip Code:45661-9757
Mailing Address - Country:US
Mailing Address - Phone:740-289-2371
Mailing Address - Fax:740-289-4291
Practice Address - Street 1:23030 STATE ROUTE 73
Practice Address - Street 2:
Practice Address - City:W PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45663-8861
Practice Address - Country:US
Practice Address - Phone:408-581-0637
Practice Address - Fax:740-858-9140
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003607101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0200599Medicaid