Provider Demographics
NPI:1356671663
Name:PIPES, SUSAN KELLI (MS LPC CAND)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:KELLI
Last Name:PIPES
Suffix:
Gender:F
Credentials:MS LPC CAND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 PARK ST SE TRLR 10A
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-8369
Mailing Address - Country:US
Mailing Address - Phone:580-222-5705
Mailing Address - Fax:
Practice Address - Street 1:602 PARK ST SE TRLR 10A
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-8369
Practice Address - Country:US
Practice Address - Phone:580-222-5705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor