Provider Demographics
NPI:1871367953
Name:SHIPLEY, ANNETTE MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:MARIE
Last Name:SHIPLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:IA
Mailing Address - Zip Code:52772-9661
Mailing Address - Country:US
Mailing Address - Phone:319-541-5690
Mailing Address - Fax:
Practice Address - Street 1:600 5TH ST STE 300
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6072
Practice Address - Country:US
Practice Address - Phone:515-233-3971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health