Provider Demographics
NPI:1396803383
Name:PIPKIN, DIANNE M (MSSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:M
Last Name:PIPKIN
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 W SPRING CREEK PKWY #105
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4507
Mailing Address - Country:US
Mailing Address - Phone:214-538-9057
Mailing Address - Fax:972-867-9057
Practice Address - Street 1:2222 W SPRING CREEK PKWY #105
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4507
Practice Address - Country:US
Practice Address - Phone:214-538-9057
Practice Address - Fax:972-867-9057
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX094981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX09498OtherLICENCED CLINICAL SOCIAL WORKER
TX11706050OtherCAQH PROVIDER ID