Provider Demographics
NPI:1275839250
Name:PHIPPS FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:PHIPPS FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERSIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:434-336-1516
Mailing Address - Street 1:139C BAKER ST
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-1703
Mailing Address - Country:US
Mailing Address - Phone:434-336-1516
Mailing Address - Fax:434-336-1517
Practice Address - Street 1:139C BAKER ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-1703
Practice Address - Country:US
Practice Address - Phone:434-336-1516
Practice Address - Fax:434-336-1517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040026301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty