Provider Demographics
NPI:1841593126
Name:PHIPPS, COLETTE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:COLETTE
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 AMANDA LANE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804
Mailing Address - Country:US
Mailing Address - Phone:914-668-8938
Mailing Address - Fax:914-668-2545
Practice Address - Street 1:6 GRAMATAN AVENUE
Practice Address - Street 2:SUITE 401 - C/O WJCS
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550
Practice Address - Country:US
Practice Address - Phone:914-668-8938
Practice Address - Fax:914-668-2545
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077654104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker