Provider Demographics
NPI:1558545434
Name:TIPPS, KRISTIN JEAN (MS, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:JEAN
Last Name:TIPPS
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 E 49TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4846
Mailing Address - Country:US
Mailing Address - Phone:405-651-4842
Mailing Address - Fax:
Practice Address - Street 1:1533 E 49TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-4846
Practice Address - Country:US
Practice Address - Phone:405-651-4842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4370101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional