Individual
MS. M SUSAN SHIPLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, ACSW, MSW
Contact information
Practice address
523 HOLSTON AVE, BRISTOL, TN 37620-2131
(423) 968-5050
Mailing address
PO BOX 1814, BRISTOL, TN 37621-1814
(423) 968-5050
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1127
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3011513
BCBS NONPAR
TN
Enumeration date
07/07/2006
Last updated
07/08/2007
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