Provider Demographics
NPI:1851428163
Name:AMY L KOPEL, LLC
Entity Type:Organization
Organization Name:AMY L KOPEL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOPEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-676-3092
Mailing Address - Street 1:311 WORTHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-7814
Mailing Address - Country:US
Mailing Address - Phone:443-676-3092
Mailing Address - Fax:
Practice Address - Street 1:1107 KENILWORTH DR
Practice Address - Street 2:SUITE 208
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2140
Practice Address - Country:US
Practice Address - Phone:410-878-7490
Practice Address - Fax:410-878-7433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD092441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty