Provider Demographics
NPI:1568480036
Name:SHEETS, TIPTON KESNER (LPC, LMFT, PLC)
Entity Type:Individual
Prefix:
First Name:TIPTON
Middle Name:KESNER
Last Name:SHEETS
Suffix:
Gender:M
Credentials:LPC, LMFT, PLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 WORMLEY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-4235
Mailing Address - Country:US
Mailing Address - Phone:757-898-9022
Mailing Address - Fax:408-676-0288
Practice Address - Street 1:603 WORMLEY CREEK DR
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-4235
Practice Address - Country:US
Practice Address - Phone:757-898-9022
Practice Address - Fax:408-676-0288
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000596101YP2500X
VA0717000220106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA132287OtherTRICARE/CHAMPUS/MHN
VA54-0537-8Medicaid
VA0007306213OtherAETNA
VA081541OtherANTHEM/BCBS