Provider Demographics
NPI:1235360710
Name:KOPSTEIN, SALLY (MSW/LCSW)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:
Last Name:KOPSTEIN
Suffix:
Gender:F
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 HIDDEN HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1063
Mailing Address - Country:US
Mailing Address - Phone:908-769-7236
Mailing Address - Fax:
Practice Address - Street 1:167 HIDDEN HOLLOW CT
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1063
Practice Address - Country:US
Practice Address - Phone:908-769-7236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-02
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44C00850001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical