1073627246 NPI number — MRS. TARI KAY HEPPE LCSW

Table of content: MRS. TARI KAY HEPPE LCSW (NPI 1073627246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073627246 NPI number — MRS. TARI KAY HEPPE LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEPPE
Provider First Name:
TARI
Provider Middle Name:
KAY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHANDLER
Provider Other First Name:
TARI
Provider Other Middle Name:
KAY
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.C.S.W.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1073627246
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11
Provider Second Line Business Mailing Address:
406 GARBER NUMBER 1
Provider Business Mailing Address City Name:
PLAINS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59859-0011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-546-8095
Provider Business Mailing Address Fax Number:
406-826-6826

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
406 GARBER NO 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59859-0011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-546-8095
Provider Business Practice Location Address Fax Number:
406-826-6826
Provider Enumeration Date:
08/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  673LCSW , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0503404 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com