Provider Demographics
NPI:1275653644
Name:TIPTON CHILDRENS FACILITY, LTD.
Entity Type:Organization
Organization Name:TIPTON CHILDRENS FACILITY, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-286-4708
Mailing Address - Street 1:521 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPINDALE
Mailing Address - State:NC
Mailing Address - Zip Code:28160-1926
Mailing Address - Country:US
Mailing Address - Phone:828-286-4708
Mailing Address - Fax:828-286-2080
Practice Address - Street 1:521 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPINDALE
Practice Address - State:NC
Practice Address - Zip Code:28160
Practice Address - Country:US
Practice Address - Phone:828-286-4708
Practice Address - Fax:828-286-2080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 103TC0700X, 103TC1900X, 103TC2200X, 103TF0000X, 103TF0200X, 103TM1800X, 103TP2701X
NC1781103T00000X, 103TC0700X, 103TC2200X
NC1905103TC0700X, 103TC1900X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Single Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005357Medicaid
NC6107192Medicaid
NC6107202Medicaid