Provider Demographics
NPI:1023375318
Name:KOPP, MEGAN M (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:M
Last Name:KOPP
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12816-0470
Mailing Address - Country:US
Mailing Address - Phone:518-258-7191
Mailing Address - Fax:
Practice Address - Street 1:142 IRISH LN
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:12816-2310
Practice Address - Country:US
Practice Address - Phone:518-258-7191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009373101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health