Provider Demographics
NPI:1386129674
Name:JEPSON, TONYA LYNN (LPC)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:LYNN
Last Name:JEPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 W 285 S
Mailing Address - Street 2:
Mailing Address - City:JEROME
Mailing Address - State:ID
Mailing Address - Zip Code:83338-5517
Mailing Address - Country:US
Mailing Address - Phone:208-970-2245
Mailing Address - Fax:
Practice Address - Street 1:413 W 285 S
Practice Address - Street 2:
Practice Address - City:JEROME
Practice Address - State:ID
Practice Address - Zip Code:83338-5517
Practice Address - Country:US
Practice Address - Phone:208-970-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health