Provider Demographics
NPI:1043792120
Name:KRPEC, KACI (LCSW)
Entity Type:Individual
Prefix:
First Name:KACI
Middle Name:
Last Name:KRPEC
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 W COLONY PL STE 130
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-7201
Mailing Address - Country:US
Mailing Address - Phone:646-457-7730
Mailing Address - Fax:
Practice Address - Street 1:21 W COLONY PL STE 130
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-7201
Practice Address - Country:US
Practice Address - Phone:646-457-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0115411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical