Healthcare Provider Details

I. General information

NPI: 1790839850
Provider Name (Legal Business Name): DONNA L RIPPELMEYER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DONNA L CAMPBELL LCSW

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 OLD HIGHWAY 40
LOVELOCK NV
89419-6401
US

IV. Provider business mailing address

20 OLD HIGHWAY 40
LOVELOCK NV
89419-6401
US

V. Phone/Fax

Practice location:
  • Phone: 573-263-1003
  • Fax:
Mailing address:
  • Phone: 573-263-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW002721
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5455-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: