Pamela Jo Tippey-Herrick, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180006970 Issued in IL

Practice address

16249 E Red Maple LN
Lewistown, IL 61542-9273

Phone

(209) 547-2117

NPI assigned

Dec 9, 2008

Last updated

Dec 9, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1376788067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16249 E RED MAPLE LN",
            "city": "LEWISTOWN",
            "state": "IL",
            "postal_code": "615429273",
            "telephone_number": "209-547-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16249 E RED MAPLE LN",
            "city": "LEWISTOWN",
            "state": "IL",
            "postal_code": "615429273",
            "telephone_number": "209-547-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPEY-HERRICK",
        "first_name": "PAMELA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180006970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phyllis Nugent, RN
• Prairie View Care Center of Lewistown
• Prairie View Care Center of Lewistown
• Prairie View Care Center of Lewistown, Inc
• Jesse J Stinauer, D.M.D.
• Sabrina Leanne Turner, L.P.C.
• Kaitlyn Van Pelt
• Kylee Marie Weaver, FNP

• Mental Health Counselor in Lewistown, IL
• Providers in Lewistown, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.