Provider Demographics
NPI:1952942625
Name:RAYNA COPPERMAN LLC
Entity Type:Organization
Organization Name:RAYNA COPPERMAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:RAYNA
Authorized Official - Middle Name:SIKOV
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:412-334-9770
Mailing Address - Street 1:146 N BELLEFIELD AVE APT 803
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2620
Mailing Address - Country:US
Mailing Address - Phone:412-334-9770
Mailing Address - Fax:
Practice Address - Street 1:5908 BRYANT ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1606
Practice Address - Country:US
Practice Address - Phone:412-334-9770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)