Provider Demographics
NPI:1659619211
Name:HIPP, CAMERON RICKENBAKER (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CAMERON
Middle Name:RICKENBAKER
Last Name:HIPP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CAMERON
Other - Middle Name:ELIZABETH
Other - Last Name:RICKENBAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:527 OLD CHEROKEE TRL
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:SC
Mailing Address - Zip Code:29138-7754
Mailing Address - Country:US
Mailing Address - Phone:803-924-0225
Mailing Address - Fax:
Practice Address - Street 1:6 COLLEGE STREET
Practice Address - Street 2:
Practice Address - City:DUE WEST
Practice Address - State:SC
Practice Address - Zip Code:29639
Practice Address - Country:US
Practice Address - Phone:864-379-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5443101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional