Provider Demographics
NPI:1659191799
Name:COPELAND, NIKOLE PATRICE (ALC)
Entity type:Individual
Prefix:
First Name:NIKOLE
Middle Name:PATRICE
Last Name:COPELAND
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 KIM CIR
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-5277
Mailing Address - Country:US
Mailing Address - Phone:205-447-6102
Mailing Address - Fax:
Practice Address - Street 1:3648 VANN RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3273
Practice Address - Country:US
Practice Address - Phone:205-447-6102
Practice Address - Fax:205-508-3008
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC05053101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor