Provider Demographics
NPI:1477785327
Name:TIPPETTS, JENNIFER BELNAP (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BELNAP
Last Name:TIPPETTS
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 1:184 SPENCER PEAK WAY
Mailing Address - Street 2:C 12
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-6949
Mailing Address - Country:US
Mailing Address - Phone:801-913-9076
Mailing Address - Fax:
Practice Address - Street 1:150 S 700 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1139
Practice Address - Country:US
Practice Address - Phone:801-364-8080
Practice Address - Fax:801-364-8098
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6441493-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical