Provider Demographics
NPI:1174827661
Name:HORTON, KIPPER S (MFT, LADC)
Entity type:Individual
Prefix:MR
First Name:KIPPER
Middle Name:S
Last Name:HORTON
Suffix:
Gender:M
Credentials:MFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W HUFFAKER LN STE 303
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2091
Mailing Address - Country:US
Mailing Address - Phone:775-621-8727
Mailing Address - Fax:
Practice Address - Street 1:180 W HUFFAKER LN STE 303
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2091
Practice Address - Country:US
Practice Address - Phone:775-621-8727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2015-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00451P101YA0400X
NV01323106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)