Provider Demographics
NPI:1629117973
Name:KOPINTO, COREY CHRISTOPHER (LCSW)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:CHRISTOPHER
Last Name:KOPINTO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 N HATFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01038-9773
Mailing Address - Country:US
Mailing Address - Phone:413-247-9355
Mailing Address - Fax:
Practice Address - Street 1:425 UNION ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4115
Practice Address - Country:US
Practice Address - Phone:413-737-1426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2137591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical