Provider Demographics
NPI:1316439821
Name:LIPFORD, KERI
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:LIPFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 COURT ST S
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271-1408
Mailing Address - Country:US
Mailing Address - Phone:304-373-1108
Mailing Address - Fax:304-373-1109
Practice Address - Street 1:235 CHURCH ST S
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-1509
Practice Address - Country:US
Practice Address - Phone:304-373-1108
Practice Address - Fax:304-373-1109
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor