Provider Demographics
NPI:1770157935
Name:KOPEC, JUSTIN BRIAN (PHD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:BRIAN
Last Name:KOPEC
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11279 PERRY HWY STE 400
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9386
Mailing Address - Country:US
Mailing Address - Phone:724-933-3910
Mailing Address - Fax:
Practice Address - Street 1:205 MILLERS RUN RD
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1348
Practice Address - Country:US
Practice Address - Phone:412-692-5992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist