Provider Demographics
NPI:1477919967
Name:KOPCZYNSKI, AUBREY (LMHC)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:KOPCZYNSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:
Other - Last Name:MALOUF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:501 CARLISLE BLVD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1507
Mailing Address - Country:US
Mailing Address - Phone:505-228-2846
Mailing Address - Fax:
Practice Address - Street 1:912 1ST ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2355
Practice Address - Country:US
Practice Address - Phone:505-224-9777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0177841101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health