Provider Demographics
NPI:1821207093
Name:SHIPP, SUSAN L (MS LPC MHSP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:L
Last Name:SHIPP
Suffix:
Gender:F
Credentials:MS LPC MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 LEE HIGHWAY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421
Mailing Address - Country:US
Mailing Address - Phone:423-855-0402
Mailing Address - Fax:423-648-9369
Practice Address - Street 1:6400 LEE HIGHWAY
Practice Address - Street 2:SUITE 106
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421
Practice Address - Country:US
Practice Address - Phone:423-855-0402
Practice Address - Fax:423-648-9369
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000001748101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional