Provider Demographics
NPI:1558766444
Name:KIPPERS, SOLA MARIE (PHD, LPC, LMFT)
Entity Type:Individual
Prefix:DR
First Name:SOLA
Middle Name:MARIE
Last Name:KIPPERS
Suffix:
Gender:F
Credentials:PHD, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 BRAKLEY DR
Mailing Address - Street 2:SUITE B2
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2333
Mailing Address - Country:US
Mailing Address - Phone:225-678-0810
Mailing Address - Fax:225-214-0068
Practice Address - Street 1:2924 BRAKLEY DR
Practice Address - Street 2:SUITE B2
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2333
Practice Address - Country:US
Practice Address - Phone:225-678-0810
Practice Address - Fax:225-214-0068
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA805106H00000X
LA2417101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist