Provider Demographics
NPI:1578864237
Name:RIPPEON, LAURA (LSCW-C, LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:RIPPEON
Suffix:
Gender:F
Credentials:LSCW-C, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8209 MARKET ST STE A
Mailing Address - Street 2:APT 296
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-9632
Mailing Address - Country:US
Mailing Address - Phone:910-312-3914
Mailing Address - Fax:844-235-9088
Practice Address - Street 1:767 S KERR AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-312-3914
Practice Address - Fax:844-235-9088
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD141851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical