Provider Demographics
NPI:1902228554
Name:GIPSON, LINDSEY (MS, LPC)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:GIPSON
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 MUSKET ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE GROVE
Mailing Address - State:AR
Mailing Address - Zip Code:72753-9348
Mailing Address - Country:US
Mailing Address - Phone:479-806-2053
Mailing Address - Fax:
Practice Address - Street 1:1 E CENTER ST
Practice Address - Street 2:SUITE 320 C
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-5349
Practice Address - Country:US
Practice Address - Phone:479-806-2053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-16
Last Update Date:2017-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1609142101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health