Provider Demographics
NPI:1780657296
Name:COPELAND, MELANIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:
Last Name:COPELAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 LLANO ST STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-5415
Mailing Address - Country:US
Mailing Address - Phone:505-424-0726
Mailing Address - Fax:
Practice Address - Street 1:1704 LLANO ST STE B
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5415
Practice Address - Country:US
Practice Address - Phone:505-424-0726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX687471041C0700X
NMC-063351041C0700X
CO099272761041C0700X
SC102691041C0700X
FL163571041C0700X
WALW000067191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical