Tabitha Peppmuller, LCSW

Individual provider Active NPI Clinical Social Worker · Peotone, IL

NPI 1831775865 · NPPES record last updated Mar 21, 2021

Key facts

NPI
1831775865
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149.020310 (IL)
Practice address
434 S Third St
Peotone, IL 60468-9251
Phone
(630) 335-9737
NPI assigned
Mar 21, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
149.020310ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.020310 IL Yes

Addresses

Primary practice location

434 S Third St
Peotone, IL 60468-9251

Mailing address

434 S Third St
Peotone, IL 60468-9251

Other names

  • Tabitha Norldof Former name

Other providers in Peotone, IL

All providers in Peotone, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.