Provider Demographics
NPI:1144783663
Name:CHAR PEPPENGER, LCSW PLLC
Entity type:Organization
Organization Name:CHAR PEPPENGER, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHAR
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PEPPENGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-370-3839
Mailing Address - Street 1:2935 STOCKYARD RD STE K4
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1567
Mailing Address - Country:US
Mailing Address - Phone:406-370-3839
Mailing Address - Fax:406-549-0282
Practice Address - Street 1:2935 STOCKYARD RD STE K4
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1567
Practice Address - Country:US
Practice Address - Phone:406-370-3839
Practice Address - Fax:406-549-0282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty