Healthcare Provider Details

I. General information

NPI: 1720438336
Provider Name (Legal Business Name): KATHRYN HEPNER LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE HEPNER LPC

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N3219 COUNTY TRUNK H STE E
LAKE GENEVA WI
53147-7074
US

IV. Provider business mailing address

1590 ELKHORN RD STE E
LAKE GENEVA WI
53147
US

V. Phone/Fax

Practice location:
  • Phone: 262-261-1409
  • Fax: 262-324-6440
Mailing address:
  • Phone: 262-261-1409
  • Fax: 262-324-6440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.011336
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178012043
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6913125
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6913-125
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: