Provider Demographics
NPI:1578850483
Name:SUTTON-LIPSEY, TAMIKA (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:
Last Name:SUTTON-LIPSEY
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 1:2508 E 71ST ST STE C
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-5572
Mailing Address - Country:US
Mailing Address - Phone:918-794-6570
Mailing Address - Fax:918-340-5189
Practice Address - Street 1:2508 E 71ST ST STE C
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5572
Practice Address - Country:US
Practice Address - Phone:918-794-6570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health