Provider Demographics
NPI:1447140702
Name:SIPPIO, DAVID (PHD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SIPPIO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 CIDER MILL LN
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-4274
Mailing Address - Country:US
Mailing Address - Phone:704-231-6560
Mailing Address - Fax:
Practice Address - Street 1:1207 CIDER MILL LN
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-4274
Practice Address - Country:US
Practice Address - Phone:704-231-6560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty