Provider Demographics
NPI:1639101967
Name:COPELAND, DAVID A (LPC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:COPELAND
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 NE INDEPENDENCE AVE
Mailing Address - Street 2:REDISCOVER
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5544
Mailing Address - Country:US
Mailing Address - Phone:816-246-8000
Mailing Address - Fax:816-246-8207
Practice Address - Street 1:901 NE INDEPENDENCE AVE
Practice Address - Street 2:REDISCOVER
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5544
Practice Address - Country:US
Practice Address - Phone:816-246-8000
Practice Address - Fax:816-246-8207
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003021868101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor