Provider Demographics
NPI:1477064699
Name:KREPPEIN, MORIAH L (LMSW)
Entity Type:Individual
Prefix:
First Name:MORIAH
Middle Name:L
Last Name:KREPPEIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 98TH ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-8400
Mailing Address - Country:US
Mailing Address - Phone:347-637-0375
Mailing Address - Fax:
Practice Address - Street 1:6820 SELFRIDGE ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5746
Practice Address - Country:US
Practice Address - Phone:347-637-0375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-15
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098824-1104100000X
NY0955751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker