Provider Demographics
NPI:1114483187
Name:HOPKINS, ALISSA (PLPC)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 QUAIL RUN RD
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-9358
Mailing Address - Country:US
Mailing Address - Phone:417-380-6510
Mailing Address - Fax:
Practice Address - Street 1:633 PERSHING ST
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:MO
Practice Address - Zip Code:65781-9790
Practice Address - Country:US
Practice Address - Phone:417-380-6510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019000949101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health