Provider Demographics
NPI:1215005970
Name:CHIPP, DONALD THOMAS (LCSW)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:THOMAS
Last Name:CHIPP
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:
Other - Last Name:CHIPP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2399 AMERICAN RIVER DR
Mailing Address - Street 2:STE. 8
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-7070
Mailing Address - Country:US
Mailing Address - Phone:916-482-4194
Mailing Address - Fax:916-974-1867
Practice Address - Street 1:2399 AMERICAN RIVER DR
Practice Address - Street 2:STE. 8
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-7070
Practice Address - Country:US
Practice Address - Phone:916-482-4194
Practice Address - Fax:916-974-1867
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL #86021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical