Provider Demographics
NPI:1124787676
Name:SHIPPEE, ANNA WALKER (LCSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:WALKER
Last Name:SHIPPEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 137
Mailing Address - Street 2:
Mailing Address - City:LENOX DALE
Mailing Address - State:MA
Mailing Address - Zip Code:01242-0137
Mailing Address - Country:US
Mailing Address - Phone:518-232-1800
Mailing Address - Fax:
Practice Address - Street 1:480 WALKER ST
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MA
Practice Address - Zip Code:01240
Practice Address - Country:US
Practice Address - Phone:518-232-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2208801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical