Provider Demographics
NPI:1306852231
Name:ZIPES, JEFFREY SCOTT
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:ZIPES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 WOODCROFT TRL
Mailing Address - Street 2:SUITE C
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45430-1995
Mailing Address - Country:US
Mailing Address - Phone:937-830-6333
Mailing Address - Fax:937-830-6333
Practice Address - Street 1:42 WOODCROFT TRL
Practice Address - Street 2:SUITE C
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45430-1995
Practice Address - Country:US
Practice Address - Phone:937-830-6333
Practice Address - Fax:937-830-6333
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011346101YA0400X
OHE2399101YM0800X
OHS-21100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker