Provider Demographics
NPI:1104333186
Name:TIPPETT, RIANN (LISW)
Entity type:Individual
Prefix:
First Name:RIANN
Middle Name:
Last Name:TIPPETT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25940 W RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-9786
Mailing Address - Country:US
Mailing Address - Phone:419-906-2709
Mailing Address - Fax:
Practice Address - Street 1:5800 MONROE ST STE A9
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2208
Practice Address - Country:US
Practice Address - Phone:419-766-9604
Practice Address - Fax:877-927-2984
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.23047831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical