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Provider Information for 1932347622


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Ms. DONNA JEAN KASPER LCPC


Sex: Female

NPI: 1932347622
Last Updated: 2020-10-22
Certification Date: 2020-10-22

Details

NameValue
NPI1932347622
Enumeration Date2009-02-03
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 4879 FOREST DR
ROCKFORD, IL 61109-4644
United States

Phone: 815-289-9212 | Fax:
 
Primary Practice Address 4879 FOREST DR
ROCKFORD, IL 61109-4644
United States

Phone: 815-289-9212 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)IL180.005851Licensed Clinical Professional Counselor
Other (non-Medicare)IL75110National Board Certified Counselor
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalIL180.005851