Provider Demographics
NPI:1245404417
Name:REPKA, DENISE KELLY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:KELLY
Last Name:REPKA
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 1:565 STENNING DR
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-9220
Mailing Address - Country:US
Mailing Address - Phone:302-234-2786
Mailing Address - Fax:
Practice Address - Street 1:565 STENNING DR
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-9220
Practice Address - Country:US
Practice Address - Phone:302-234-2786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00008121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical