Provider Demographics
NPI:1033131263
Name:KEPNER, REBECCA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:KEPNER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:TEMPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 PARK CENTER CT
Mailing Address - Street 2:SUITE 211
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5601
Mailing Address - Country:US
Mailing Address - Phone:410-356-8383
Mailing Address - Fax:
Practice Address - Street 1:6 PARK CENTER CT
Practice Address - Street 2:SUITE 211
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5601
Practice Address - Country:US
Practice Address - Phone:410-356-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD125401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH103JEOtherCAREFIRST