Individual
ADDYSON STIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
908 S WALTON BLVD STE 39, BENTONVILLE, AR 72712-6287
(479) 308-1833
Mailing address
4000 S DIXIELAND RD APT Q102, ROGERS, AR 72758-1802
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
A1810148
AR
101YP2500X
Professional Counselor
Primary
P2105010
AR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227125795
—
AR
Enumeration date
01/23/2018
Last updated
07/13/2021
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