Provider Demographics
NPI:1487951265
Name:SHIPMAN, LINDSEY
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:SHIPMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12383 ELIZABETH DR
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-4942
Mailing Address - Country:US
Mailing Address - Phone:405-615-9272
Mailing Address - Fax:405-610-2162
Practice Address - Street 1:12383 ELIZABETH DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-4942
Practice Address - Country:US
Practice Address - Phone:405-615-9272
Practice Address - Fax:405-610-2162
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4706101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health