Provider Demographics
NPI:1003251521
Name:COPELAND, JENNIFER CHRISTINE (LPC, NCC)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:CHRISTINE
Last Name:COPELAND
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:CHRISTINE
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC ,NCC
Mailing Address - Street 1:135 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-1559
Mailing Address - Country:US
Mailing Address - Phone:814-860-2000
Mailing Address - Fax:814-860-2110
Practice Address - Street 1:135 E 38TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504-1559
Practice Address - Country:US
Practice Address - Phone:814-860-2000
Practice Address - Fax:814-860-2110
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-10
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005879101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional