Provider Demographics
NPI:1679726988
Name:PETER C. KLEPONIS, P.C.
Entity Type:Organization
Organization Name:PETER C. KLEPONIS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/LICENSED THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:KLEPONIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:610-397-0960
Mailing Address - Street 1:100 FOUR FALLS CORPORATE CENTER
Mailing Address - Street 2:SUITE 312
Mailing Address - City:WEST CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428
Mailing Address - Country:US
Mailing Address - Phone:610-397-0960
Mailing Address - Fax:610-397-0954
Practice Address - Street 1:100 FOUR FALLS CORPORATE CENTER
Practice Address - Street 2:SUITE 312
Practice Address - City:WEST CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428
Practice Address - Country:US
Practice Address - Phone:610-397-0960
Practice Address - Fax:610-397-0954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003470101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty