Kelly Renee Tipton, M.A., L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2006035741 Issued in MO

Practice address

655 Craig Rd
Suite 320
Creve Coeur, MO 63141-7132

Phone

(314) 374-4703

Fax

(314) 457-1653

NPI assigned

Jun 5, 2008

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1710146782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 CRAIG RD",
            "address_2": "SUITE 320",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417132",
            "telephone_number": "314-374-4703",
            "fax_number": "314-457-1653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 CRAIG RD",
            "address_2": "SUITE 320",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417132",
            "telephone_number": "314-374-4703",
            "fax_number": "314-457-1653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "KELLY",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "M.A., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2006035741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.