Provider Demographics
NPI:1578966537
Name:COPPOLA, KAREN R (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:COPPOLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 STATE ROUTE 38B
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-6307
Mailing Address - Country:US
Mailing Address - Phone:607-748-2287
Mailing Address - Fax:
Practice Address - Street 1:3390 HANCE RD
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-5756
Practice Address - Country:US
Practice Address - Phone:607-669-4891
Practice Address - Fax:607-669-4891
Is Sole Proprietor?:No
Enumeration Date:2014-10-06
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator