Provider Demographics
NPI:1538508486
Name:PHIPPS, TREVOR SCOTT (LMSW)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:SCOTT
Last Name:PHIPPS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W SHORT ST
Mailing Address - Street 2:
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-2257
Mailing Address - Country:US
Mailing Address - Phone:641-745-0639
Mailing Address - Fax:
Practice Address - Street 1:600 5TH ST STE 200
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6071
Practice Address - Country:US
Practice Address - Phone:515-232-2051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0082121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical