Provider Demographics
NPI:1720438336
Name:HEPNER, KATHRYN (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:HEPNER
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:HEPNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:N3219 COUNTY TRUNK H STE E
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-7074
Mailing Address - Country:US
Mailing Address - Phone:262-261-1409
Mailing Address - Fax:262-324-6440
Practice Address - Street 1:N3219 COUNTY TRUNK H STE E
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-7074
Practice Address - Country:US
Practice Address - Phone:262-261-1409
Practice Address - Fax:262-324-6440
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6913125101YM0800X
180.011336101YP2500X
IL178012043101YP2500X
6913-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional