Provider Demographics
NPI:1477893659
Name:LOPEZ-SHIPMAN, JOSETTE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:JOSETTE
Middle Name:
Last Name:LOPEZ-SHIPMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5332 RIVEREDGE DR
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-7338
Mailing Address - Country:US
Mailing Address - Phone:321-264-4033
Mailing Address - Fax:321-264-4034
Practice Address - Street 1:5332 RIVEREDGE DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-7338
Practice Address - Country:US
Practice Address - Phone:321-264-4033
Practice Address - Fax:321-264-4034
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8590101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health