Provider Demographics
NPI:1043828924
Name:SHIPP, ARIELLE (LPC, PMH-C)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:SHIPP
Suffix:
Gender:F
Credentials:LPC, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-5205
Mailing Address - Country:US
Mailing Address - Phone:757-965-8663
Mailing Address - Fax:757-539-8834
Practice Address - Street 1:109 CLAY ST
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5205
Practice Address - Country:US
Practice Address - Phone:757-965-8663
Practice Address - Fax:757-539-8834
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012522101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional