Provider Demographics
NPI:1265673305
Name:SHIPP, PATTI P (LPC, MAC)
Entity type:Individual
Prefix:
First Name:PATTI
Middle Name:P
Last Name:SHIPP
Suffix:
Gender:
Credentials:LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CAMP RD
Mailing Address - Street 2:
Mailing Address - City:EASTANOLLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30538-3085
Mailing Address - Country:US
Mailing Address - Phone:709-903-7547
Mailing Address - Fax:
Practice Address - Street 1:46 WALL STREET WAY UNIT 2
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-6236
Practice Address - Country:US
Practice Address - Phone:770-990-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004304101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health