Provider Demographics
NPI:1740586148
Name:KATOPIS, ALEXANDER GEORGE (LCPC)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:GEORGE
Last Name:KATOPIS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WALKER ST
Mailing Address - Street 2:UNIT #3
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-5200
Mailing Address - Country:US
Mailing Address - Phone:207-400-0270
Mailing Address - Fax:
Practice Address - Street 1:3 WALKER ST
Practice Address - Street 2:UNIT #3
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-5200
Practice Address - Country:US
Practice Address - Phone:207-400-0270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4120101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional