Provider Demographics
NPI:1811506033
Name:KREPPS, BRYANN (BA)
Entity type:Individual
Prefix:
First Name:BRYANN
Middle Name:
Last Name:KREPPS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 OVERLAND ST
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-4619
Mailing Address - Country:US
Mailing Address - Phone:857-615-1531
Mailing Address - Fax:
Practice Address - Street 1:440 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1225
Practice Address - Country:US
Practice Address - Phone:603-889-6147
Practice Address - Fax:603-595-0758
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW228578104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator