Provider Demographics
NPI:1326263716
Name:COPELAND, FREEDA
Entity Type:Individual
Prefix:MS
First Name:FREEDA
Middle Name:
Last Name:COPELAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 N WESTMORELAND RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-1655
Mailing Address - Country:US
Mailing Address - Phone:214-333-7093
Mailing Address - Fax:214-948-2474
Practice Address - Street 1:1353 N. WESTMORELNAD RD.
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-0000
Practice Address - Country:US
Practice Address - Phone:214-333-7093
Practice Address - Fax:214-948-2474
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2323555Medicaid