Provider Demographics
NPI:1982105094
Name:SHIPLEY, JANET ERICKSON (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:ERICKSON
Last Name:SHIPLEY
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 1:16435 MEREDREW LN
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6375
Mailing Address - Country:US
Mailing Address - Phone:407-293-4335
Mailing Address - Fax:
Practice Address - Street 1:102 W DIXIE AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6351
Practice Address - Country:US
Practice Address - Phone:352-323-8872
Practice Address - Fax:352-801-7376
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6470101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health