Provider Demographics
NPI:1326340332
Name:RIPPETOE, JANIE M (LCSW)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:M
Last Name:RIPPETOE
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:P.O. BOX 738
Mailing Address - Street 2:
Mailing Address - City:PANACA
Mailing Address - State:NV
Mailing Address - Zip Code:89042-0738
Mailing Address - Country:US
Mailing Address - Phone:759-628-0897
Mailing Address - Fax:775-728-4166
Practice Address - Street 1:1005 MAIN ST
Practice Address - Street 2:
Practice Address - City:PANACA
Practice Address - State:NV
Practice Address - Zip Code:89042
Practice Address - Country:US
Practice Address - Phone:775-962-8089
Practice Address - Fax:775-728-4166
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11419-C1041C0700X
NV9359-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker