Provider Demographics
NPI:1609016112
Name:KUPERMAN-CORWIN, LAURA JAYNE (MSW, LCSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:JAYNE
Last Name:KUPERMAN-CORWIN
Suffix:
Gender:F
Credentials:MSW, LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 INVERNESS LN
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-2818
Mailing Address - Country:US
Mailing Address - Phone:413-567-6366
Mailing Address - Fax:
Practice Address - Street 1:141 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-3638
Practice Address - Country:US
Practice Address - Phone:413-592-5414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2009-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0049141041C0700X
MA1104261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical