Provider Demographics
NPI:1205242757
Name:TIPPIN, TOI RENEE (MA, LPC)
Entity type:Individual
Prefix:
First Name:TOI
Middle Name:RENEE
Last Name:TIPPIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9434 WAXWING ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-5031
Mailing Address - Country:US
Mailing Address - Phone:361-208-4166
Mailing Address - Fax:
Practice Address - Street 1:9434 WAXWING ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-5031
Practice Address - Country:US
Practice Address - Phone:361-208-4166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-05
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68701101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional