KATHLEEN DIEPENBROCK LPC - NPI 1700325461

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

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About Kathleen Diepenbrock Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHLEEN DIEPENBROCK LPC (NPI 1700325461) is an individual counselor in Hailey, Idaho, licensed in Idaho (LPC -4732) and active in the NPI registry since February 2017.

NPPES Registry Identity

NPI1700325461

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameKATHLEEN DIEPENBROCKCredential: LPC

Location Address314 S RIVER ST, SUITE 202Hailey, ID 83333-8851

Mailing AddressPo Box 4683Hailey, ID 83333-4683 · (208) 720-0941 · Fax (208) 788-5692

Phone(208) 788-5625

Fax(208) 788-5692

Sole ProprietorYes

Enumeration DateFebruary 14, 2017

✔ NPI 1700325461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in ID · LPC -4732

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

314 S RIVER ST, Hailey, ID 83333

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