Provider Demographics
NPI:1588194757
Name:COPLEN, LORI DENISE YOUNTS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:DENISE YOUNTS
Last Name:COPLEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:DENISE
Other - Last Name:YOUNTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1205 SHARONDALE DR
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-4553
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1205 SHARONDALE DR
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-4553
Practice Address - Country:US
Practice Address - Phone:817-715-2476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX270601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical