Provider Demographics
NPI:1083895403
Name:COPING EAP
Entity Type:Organization
Organization Name:COPING EAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:KUTNER
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:843-449-8318
Mailing Address - Street 1:223 MAISON DR UNIT 28
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-5170
Mailing Address - Country:US
Mailing Address - Phone:843-449-8318
Mailing Address - Fax:843-497-5441
Practice Address - Street 1:223 MAISON DR UNIT 28
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-5170
Practice Address - Country:US
Practice Address - Phone:843-449-8318
Practice Address - Fax:843-497-5441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLISW-CP 5739251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health