Provider Demographics
NPI:1780187419
Name:COPELAND, ANNA LOUISE (LISW)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:LOUISE
Last Name:COPELAND
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1867 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6901
Mailing Address - Country:US
Mailing Address - Phone:330-812-3890
Mailing Address - Fax:
Practice Address - Street 1:1867 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313
Practice Address - Country:US
Practice Address - Phone:330-812-3890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-08
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1500392104100000X
OHI.18009871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker