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General NPI Number Information
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NPI Number | 1174893895
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Entity Type | Individual
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Provider Name | MICHELLE RENEE KEPPLER LSCSW, LMAC
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Gender | Female
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 301 NE MULBERRY ST STE 200
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City | LEE'S SUMMIT
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State | MO
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Zip | 64086-6017
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Country | US
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Telephone | 816-932-1711
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Fax | 816-932-1719
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Provider Business Mailing Address
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Address Line | 901 E 104TH ST MAILSTOP 400S
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City | KANSAS CITY
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State | MO
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Zip | 64131-4517
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Country | US
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Telephone | 816-932-5678
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Fax | 816-932-9670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 429
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2023018243
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4777
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License Number State | KS
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