Provider Demographics
NPI:1609218445
Name:KAPER, KIM A (LPC)
Entity Type:Individual
Prefix:MS
First Name:KIM
Middle Name:A
Last Name:KAPER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:KIM
Other - Middle Name:
Other - Last Name:BOARDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PPC
Mailing Address - Street 1:PO BOX 646
Mailing Address - Street 2:
Mailing Address - City:SUNDANCE
Mailing Address - State:WY
Mailing Address - Zip Code:82729-0646
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 1/2 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SUNDANCE
Practice Address - State:WY
Practice Address - Zip Code:82729-0646
Practice Address - Country:US
Practice Address - Phone:307-283-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-1750101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional