Provider Demographics
NPI:1104997352
Name:PIPES, RONNY (MA, LPC-S)
Entity type:Individual
Prefix:MR
First Name:RONNY
Middle Name:
Last Name:PIPES
Suffix:
Gender:M
Credentials:MA, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13896 MAXWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-9228
Mailing Address - Country:US
Mailing Address - Phone:817-689-7887
Mailing Address - Fax:214-648-0167
Practice Address - Street 1:4913 RUFE SNOW DR
Practice Address - Street 2:SUITE 101-C
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7856
Practice Address - Country:US
Practice Address - Phone:817-689-7887
Practice Address - Fax:214-648-0167
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012726101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10009361Medicaid