Provider Demographics
NPI:1568740462
Name:NEPUTE, JEFF (PHD)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:
Last Name:NEPUTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 W. LAKE ST.
Mailing Address - Street 2:8031 CAMPUS DELIVERY
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80523-8031
Mailing Address - Country:US
Mailing Address - Phone:970-491-3649
Mailing Address - Fax:
Practice Address - Street 1:8031 CAMPUS DELIVERY
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-1876
Practice Address - Country:US
Practice Address - Phone:970-491-3649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004400103T00000X
COPSY0004400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist