Provider Demographics
NPI:1609984384
Name:OPPER, PATRICIA S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:S
Last Name:OPPER
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 1:10084 41ST DR S
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4202
Mailing Address - Country:US
Mailing Address - Phone:303-521-5408
Mailing Address - Fax:
Practice Address - Street 1:10084 41ST DR S
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4202
Practice Address - Country:US
Practice Address - Phone:303-521-5408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW111191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOB 4872Medicare UPIN