Provider Demographics
NPI:1790997823
Name:PHIPPS, AIMEE (LISW-CP)
Entity Type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 COLONIAL DR
Mailing Address - Street 2:WILSON BUILDING
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6827
Mailing Address - Country:US
Mailing Address - Phone:803-898-2396
Mailing Address - Fax:803-898-1471
Practice Address - Street 1:1800 COLONIAL DR
Practice Address - Street 2:WILSON BUILDING
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6827
Practice Address - Country:US
Practice Address - Phone:803-898-2396
Practice Address - Fax:803-898-1471
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8738104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker