Provider Demographics
NPI:1538486394
Name:COPENHAVER, LORRAINE RAE (BSW,MSW)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:RAE
Last Name:COPENHAVER
Suffix:
Gender:F
Credentials:BSW,MSW
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:RAE
Other - Last Name:SEILHAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:214 PEACH ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:MC CONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233-8559
Mailing Address - Country:US
Mailing Address - Phone:717-485-5342
Mailing Address - Fax:717-485-4716
Practice Address - Street 1:214 PEACH ORCHARD RD
Practice Address - Street 2:
Practice Address - City:MC CONNELLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17233-8559
Practice Address - Country:US
Practice Address - Phone:717-485-5342
Practice Address - Fax:717-485-4716
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW127791101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health