Provider Demographics
NPI:1063544054
Name:REPPE, NANCY K (LCPC)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:K
Last Name:REPPE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7297
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59406-7297
Mailing Address - Country:US
Mailing Address - Phone:406-452-1190
Mailing Address - Fax:
Practice Address - Street 1:1321 8TH AVE N
Practice Address - Street 2:SUITE 203
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-1646
Practice Address - Country:US
Practice Address - Phone:406-452-1190
Practice Address - Fax:406-452-1190
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT435101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT253591Medicaid