Provider Demographics
NPI:1710267299
Name:POPLOSKI, JEFFREY PAUL (PHARMD, LPC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PAUL
Last Name:POPLOSKI
Suffix:
Gender:M
Credentials:PHARMD, LPC
Other - Prefix:
Other - First Name:JEFFREY
Other - Middle Name:PAUL
Other - Last Name:POPLOSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COUNSELOR TRAINEE
Mailing Address - Street 1:4918 YORKSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-3728
Mailing Address - Country:US
Mailing Address - Phone:412-400-9138
Mailing Address - Fax:
Practice Address - Street 1:20800 CENTER RIDGE RD STE 410
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-4306
Practice Address - Country:US
Practice Address - Phone:440-356-7620
Practice Address - Fax:440-356-7623
Is Sole Proprietor?:No
Enumeration Date:2011-08-28
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03125741183500000X
390200000X
OHC.2002503101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program