Basic Information
| Provider Information | |||||||||
| NPI: | 1346376167 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHIPPERS | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | LEONARD | ||||||||
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| Credential: | LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 195 W WARNER ST | ||||||||
| Address2: | |||||||||
| City: | YPSILANTI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481974709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3472559306 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2140 E ELLSWORTH RD | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481082552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342223500 | ||||||||
| FaxNumber: | 7349712487 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 08/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 6361005430 | MI | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103T00000X | 6301011477 | MI | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.