Provider Demographics
NPI:1205132891
Name:ROSS-COPES, STEPHANIE (LPN,CPC-I,LADC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ROSS-COPES
Suffix:
Gender:F
Credentials:LPN,CPC-I,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 SNYDER AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-2943
Mailing Address - Country:US
Mailing Address - Phone:215-302-7957
Mailing Address - Fax:702-636-1393
Practice Address - Street 1:686 W CUTHBERT BLVD UNIT 213
Practice Address - Street 2:
Practice Address - City:HADDON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08108-3642
Practice Address - Country:US
Practice Address - Phone:215-302-7957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00878101YA0400X
101YM0800X, 101YP2500X
NVLPN15661164W00000X
NVCP0269101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVLPN15661OtherBOARD OF NURSING