Provider Demographics
NPI:1164546891
Name:TIPPEY, LINDA LOU (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LOU
Last Name:TIPPEY
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-2946
Mailing Address - Country:US
Mailing Address - Phone:309-344-4200
Mailing Address - Fax:309-344-4281
Practice Address - Street 1:2323 WINDISH DR
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-9780
Practice Address - Country:US
Practice Address - Phone:309-344-4374
Practice Address - Fax:309-344-4281
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-001076101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL370984175OtherFEIN ORGANIZATION
IL180-001076OtherSTATE OF ILLINOIS