Provider Demographics
NPI:1851806830
Name:SHIPPS, KRYSTAL MAE (MA, T-LPC)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:MAE
Last Name:SHIPPS
Suffix:
Gender:F
Credentials:MA, T-LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10925 ANTIOCH RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2119
Mailing Address - Country:US
Mailing Address - Phone:816-200-7626
Mailing Address - Fax:
Practice Address - Street 1:7133 W. 95TH ST., SUITE 216
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212
Practice Address - Country:US
Practice Address - Phone:816-200-7626
Practice Address - Fax:816-200-7626
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03441-LCPC101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor