Provider Demographics
NPI:1477713980
Name:KREPPS, MICHELLE ROSE (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ROSE
Last Name:KREPPS
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12627 W 143RD ST
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-8381
Mailing Address - Country:US
Mailing Address - Phone:708-590-6833
Mailing Address - Fax:708-590-6804
Practice Address - Street 1:12627 W 143RD ST
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-8381
Practice Address - Country:US
Practice Address - Phone:708-645-0798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490128741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical