Provider Demographics
NPI:1780813345
Name:COPP, RAYMOND WALTER (PHD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:WALTER
Last Name:COPP
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 1:564 SPRING OAK DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-1757
Mailing Address - Country:US
Mailing Address - Phone:610-639-1082
Mailing Address - Fax:610-429-9939
Practice Address - Street 1:564 SPRING OAK DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-1757
Practice Address - Country:US
Practice Address - Phone:610-639-1082
Practice Address - Fax:610-429-9939
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-03
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
WARC60103553103TC0700X
WAHP60107685103TC0700X
CTHYP0000284103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling