Provider Demographics
NPI:1982918744
Name:IPPOLITO, JAMES (MA, LMFT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:IPPOLITO
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 WILLIAMS DR STE 301
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-3195
Mailing Address - Country:US
Mailing Address - Phone:615-653-4115
Mailing Address - Fax:615-413-9995
Practice Address - Street 1:1608 WILLIAMS DR STE 301
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3195
Practice Address - Country:US
Practice Address - Phone:615-653-4115
Practice Address - Fax:615-413-9995
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55060106H00000X
TN2541106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist