Provider Demographics
NPI:1619730165
Name:WINGFIELD, PIPPI M (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:PIPPI
Middle Name:M
Last Name:WINGFIELD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8707 MCKIBBEN DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-5530
Mailing Address - Country:US
Mailing Address - Phone:804-350-5336
Mailing Address - Fax:804-222-3232
Practice Address - Street 1:2430 SOUTHLAND DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-2354
Practice Address - Country:US
Practice Address - Phone:804-528-4331
Practice Address - Fax:804-222-3232
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904015990101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional