Healthcare Provider Details

I. General information

NPI: 1407375629
Provider Name (Legal Business Name): JULIE PEPIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE TAMBLYN

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W MAIN ST
FRISCO CO
80443-5513
US

IV. Provider business mailing address

PO BOX 3751
DILLON CO
80435-3751
US

V. Phone/Fax

Practice location:
  • Phone: 970-239-3697
  • Fax:
Mailing address:
  • Phone: 970-239-3697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0016432
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: