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Individual

MILDRED LADEAN PHIPPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, LCAS

Contact information

Practice address
284 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1831
(704) 939-1100
(704) 939-1173
Mailing address
284 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1831
(704) 939-1100
(704) 939-1173

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
129
NC
101YM0800X
Mental Health Counselor
3258

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6102362
NC
Enumeration date
12/19/2007
Last updated
07/31/2013
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