Provider Demographics
NPI:1265018782
Name:PHIPPS, PAMELA J (LPC)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:J
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6760 HWY 98
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-8817
Mailing Address - Country:US
Mailing Address - Phone:601-402-5137
Mailing Address - Fax:
Practice Address - Street 1:6760 HWY 98
Practice Address - Street 2:SUITE 1
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-8817
Practice Address - Country:US
Practice Address - Phone:601-402-5137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2671101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health