Provider Demographics
NPI:1841682994
Name:SCHOPFEL, MARY (MA, LPC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SCHOPFEL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 W TEMPLE ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-5654
Mailing Address - Country:US
Mailing Address - Phone:215-990-9240
Mailing Address - Fax:
Practice Address - Street 1:901 PACIFIC COAST HIGHWAY
Practice Address - Street 2:200A
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277
Practice Address - Country:US
Practice Address - Phone:310-316-1610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.009912101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional