Provider Demographics
NPI:1669557807
Name:KOPIT, LON (PSYD)
Entity type:Individual
Prefix:DR
First Name:LON
Middle Name:
Last Name:KOPIT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7940 S UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-5104
Mailing Address - Country:US
Mailing Address - Phone:303-770-1700
Mailing Address - Fax:303-221-2500
Practice Address - Street 1:7940 S UNIVERSITY BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-5104
Practice Address - Country:US
Practice Address - Phone:303-770-1700
Practice Address - Fax:303-221-2500
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4218101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health