Provider Demographics
NPI:1336121839
Name:KOPPER, SARA JOY (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:JOY
Last Name:KOPPER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:JOY
Other - Last Name:BEDSWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LBSW
Mailing Address - Street 1:804 WESTERN HEIGHTS CIR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:KS
Mailing Address - Zip Code:67063-1163
Mailing Address - Country:US
Mailing Address - Phone:620-947-3200
Mailing Address - Fax:
Practice Address - Street 1:804 WESTERN HEIGHTS
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:KS
Practice Address - Zip Code:67063-1163
Practice Address - Country:US
Practice Address - Phone:620-947-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS59421041C0700X
KS37781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical