Provider Demographics
NPI:1255563748
Name:RIPSON, BERNICE A (LCSW)
Entity type:Individual
Prefix:DR
First Name:BERNICE
Middle Name:A
Last Name:RIPSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34620 PALMETTO DR
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2638
Mailing Address - Country:US
Mailing Address - Phone:727-576-6281
Mailing Address - Fax:
Practice Address - Street 1:34620 PALMETTO DR
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2638
Practice Address - Country:US
Practice Address - Phone:727-576-6281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW80931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical