Provider Demographics
NPI:1477149268
Name:SHIPMAN, MECHELE LEE (EDD, MSW, LCISW LCSW)
Entity Type:Individual
Prefix:DR
First Name:MECHELE
Middle Name:LEE
Last Name:SHIPMAN
Suffix:
Gender:F
Credentials:EDD, MSW, LCISW LCSW
Other - Prefix:
Other - First Name:MECHELE
Other - Middle Name:L
Other - Last Name:PITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD, MSW, LCISW LCSW
Mailing Address - Street 1:18564 54TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-8750
Mailing Address - Country:US
Mailing Address - Phone:171-579-7098
Mailing Address - Fax:
Practice Address - Street 1:18564 54TH AVE
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-8750
Practice Address - Country:US
Practice Address - Phone:171-579-7098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN215791041C0700X
WI7621-20231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical