| Doctor Name: | MS. NANCY MARIE CHARPENTIER-PROBST |
| NPI Number: | 1013129212 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 149007207 |
| Business Practice Address: | 204 W University Ave Urbana, IL - 618011741 |
| Business Phone Number: | 2173833202 |
| Business Fax Number: | 2173283581 |
| Mailing Address: | 611 W. Park St., Bwpc URBANA |
| State: | IL |
| Postal Code: | 618012500 |
| Phone Number: | 2173836792 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 12/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149007207 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |