Provider Demographics
NPI:1457780678
Name:CHIPP, CODY (PHD)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:CHIPP
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 DENALI ST STE 205
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4039
Mailing Address - Country:US
Mailing Address - Phone:907-227-6167
Mailing Address - Fax:844-927-4604
Practice Address - Street 1:3501 DENALI ST STE 205
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4039
Practice Address - Country:US
Practice Address - Phone:907-227-6167
Practice Address - Fax:844-927-4604
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK655103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical