Provider Demographics
NPI:1124546296
Name:PEPEN, IVELIN MERCEDES (MFT)
Entity Type:Individual
Prefix:
First Name:IVELIN
Middle Name:MERCEDES
Last Name:PEPEN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 BUTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3223
Mailing Address - Country:US
Mailing Address - Phone:484-802-4819
Mailing Address - Fax:
Practice Address - Street 1:419 BUTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3223
Practice Address - Country:US
Practice Address - Phone:484-802-4819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty