Active NPI
Kristin Tipps, LPC
- Professional Counselor
- Fort Myers, FL
National Provider Identifier
1356715288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C-06523
- Practice address
- 2789 Ortiz Ave
Fort Myers, FL 33905-7806 - Phone
- (239) 275-3222
- Fax
- (239) 791-0111
- NPI assigned
- Nov 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C-06523 | OH | Primary |
Addresses
Primary practice location
2789 Ortiz Ave
Fort Myers, FL 33905-7806
Mailing address
3763 Evans Ave
Fort Myers, FL 33901-9302
Phone (239) 275-3222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-06523 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1356715288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3763 EVANS AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339019302",
"telephone_number": "239-275-3222",
"fax_number": "239-791-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2789 ORTIZ AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339057806",
"telephone_number": "239-275-3222",
"fax_number": "239-791-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIPPS",
"first_name": "KRISTIN",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-16",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C-06523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.