Provider Demographics
NPI:1366041147
Name:FIPPS, COLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:COLEY
Middle Name:
Last Name:FIPPS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-0133
Mailing Address - Country:US
Mailing Address - Phone:918-691-7232
Mailing Address - Fax:
Practice Address - Street 1:1200 CHILDREN AVE
Practice Address - Street 2:SUITE 6-A
Practice Address - City:OKLAHOMA
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:918-691-7232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK46081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical