Provider Demographics
NPI:1245384064
Name:PEPLINSKI, KELLY ANN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:PEPLINSKI
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 DONNA MARIE DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-6900
Mailing Address - Country:US
Mailing Address - Phone:314-550-5262
Mailing Address - Fax:
Practice Address - Street 1:2705 MULLANPHY LN
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-3727
Practice Address - Country:US
Practice Address - Phone:314-830-6210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002010854101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional