Provider Demographics
NPI:1023686417
Name:SHELBY SIPE PROFESSIONAL COUNSELING
Entity type:Organization
Organization Name:SHELBY SIPE PROFESSIONAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIPE
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC, NCC
Authorized Official - Phone:317-544-8413
Mailing Address - Street 1:196 BLASTED ROCK RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4374
Mailing Address - Country:US
Mailing Address - Phone:317-544-8413
Mailing Address - Fax:
Practice Address - Street 1:861E N DEAN RD STE B
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-9419
Practice Address - Country:US
Practice Address - Phone:334-707-8639
Practice Address - Fax:334-888-8298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4437OtherALABAMA BOARD OF EXAMINERS IN COUNSELING