Provider Demographics
NPI:1083602387
Name:COPELAND, JOHN S (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:S
Last Name:COPELAND
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 KENT PL
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-0768
Mailing Address - Country:US
Mailing Address - Phone:757-436-0605
Mailing Address - Fax:757-436-0023
Practice Address - Street 1:809 KENT PL
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-0768
Practice Address - Country:US
Practice Address - Phone:757-436-0605
Practice Address - Fax:757-436-0023
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003688101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
083061MOtherSENTARA
247984OtherCOMPSYCH
353857OtherMHN
VA010137144Medicaid
VA175196OtherBC/BS