Active NPI
Judith Joan Phipps, MS
- Mental Health Counselor
- Lawrenceville, IL
National Provider Identifier
1366678161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 036-105698
- Practice address
- RR1 Box 277
Lawrenceville, IL 62439 - Phone
- (618) 943-3754
- Fax
- (618) 943-3754
- NPI assigned
- Jun 8, 2009
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 036-105698 | IL | Primary |
Addresses
Primary practice location
RR1 Box 277
Lawrenceville, IL 62439
Mailing address
P.O. Box 516
Lawrenceville, IL 62439
Phone (618) 943-3754
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37600178008 | Medicaid | IL |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-105698 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244419200000",
"number": "1366678161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 516",
"city": "LAWRENCEVILLE",
"state": "IL",
"postal_code": "62439",
"telephone_number": "618-943-3754",
"fax_number": "618-943-3657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR1 BOX 277",
"city": "LAWRENCEVILLE",
"state": "IL",
"postal_code": "62439",
"telephone_number": "618-943-3754",
"fax_number": "618-943-3754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHIPPS",
"first_name": "JUDITH",
"middle_name": "JOAN",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-08",
"last_updated": "2009-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "036-105698",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "37600178008",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.