Provider Demographics
NPI:1740737220
Name:SHIPP, ELLEN DEANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:DEANN
Last Name:SHIPP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ELLEN
Other - Middle Name:DEANN
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1049 NORTH PINE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:OLLA
Mailing Address - State:LA
Mailing Address - Zip Code:71465-4804
Mailing Address - Country:US
Mailing Address - Phone:318-495-0758
Mailing Address - Fax:318-495-0751
Practice Address - Street 1:1049 NORTH PINE RD
Practice Address - Street 2:SUITE D
Practice Address - City:OLLA
Practice Address - State:LA
Practice Address - Zip Code:71465-4804
Practice Address - Country:US
Practice Address - Phone:318-495-0758
Practice Address - Fax:318-495-0751
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA115251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical