Provider Demographics
NPI:1346376167
Name:SCHIPPERS, JOHN LEONARD (LLP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:LEONARD
Last Name:SCHIPPERS
Suffix:
Gender:M
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 W WARNER ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-4709
Mailing Address - Country:US
Mailing Address - Phone:347-255-9306
Mailing Address - Fax:
Practice Address - Street 1:2140 E ELLSWORTH RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2552
Practice Address - Country:US
Practice Address - Phone:734-222-3500
Practice Address - Fax:734-971-2487
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361005430103TC0700X
MI6301011477103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical