Healthcare Provider Details

I. General information

NPI: 1700480480
Provider Name (Legal Business Name): PEPPLER & SEMBER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2020
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N MAIN ST
VASSAR MI
48768-1319
US

IV. Provider business mailing address

5200 COTTRELL RD
VASSAR MI
48768-9000
US

V. Phone/Fax

Practice location:
  • Phone: 989-233-9179
  • Fax:
Mailing address:
  • Phone: 989-233-9179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KORTNEY PEPPLER
Title or Position: OWNER
Credential: LMSW
Phone: 989-484-2741