Provider Demographics
NPI:1821735465
Name:SHIPLEY, MELODY (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:SHIPLEY
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 WEATHERLY DR STE A
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-8910
Mailing Address - Country:US
Mailing Address - Phone:877-467-3123
Mailing Address - Fax:
Practice Address - Street 1:775 WEATHERLY DR STE A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8910
Practice Address - Country:US
Practice Address - Phone:877-467-3123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health