Provider Demographics
NPI:1811106859
Name:CHOPKO, BRIAN ANDREW (MA ED, PC,)
Entity type:Individual
Prefix:PROF
First Name:BRIAN
Middle Name:ANDREW
Last Name:CHOPKO
Suffix:
Gender:M
Credentials:MA ED, PC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 OWAISA RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-2925
Mailing Address - Country:US
Mailing Address - Phone:330-920-1197
Mailing Address - Fax:
Practice Address - Street 1:1871 6TH ST
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3819
Practice Address - Country:US
Practice Address - Phone:330-285-7472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0501017101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional