| Doctor Name: | JOHN T PHIPPS |
| NPI Number: | 1124116090 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | SW8410 |
| Business Practice Address: | 1213 State Road 20 Interlachen, FL - 321482737 |
| Business Phone Number: | 3866844914 |
| Business Fax Number: | |
| Mailing Address: | 1302 River St, PALATKA |
| State: | FL |
| Postal Code: | 321775042 |
| Phone Number: | 3863280108 |
| Fax Number: | 3863251086 |
| NPI Enumeration Date: | 10/10/2006 |
| NPI Last Update Date: | 05/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW8410 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |