Provider Demographics
NPI:1386809358
Name:KERPA, KELLI J (BS, LAC)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:J
Last Name:KERPA
Suffix:
Gender:F
Credentials:BS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N LAST CHANCE GULCH
Mailing Address - Street 2:SUITE 2A ARCADE BUILDING
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4125
Mailing Address - Country:US
Mailing Address - Phone:406-443-1990
Mailing Address - Fax:406-443-1391
Practice Address - Street 1:111 N LAST CHANCE GULCH
Practice Address - Street 2:SUITE 2A ARCADE BUILDING
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4125
Practice Address - Country:US
Practice Address - Phone:406-443-1990
Practice Address - Fax:406-443-1391
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1234101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)