Phillipe Wayne Copeland, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113764 Issued in MA

Practice address

201 River St
Mattapan, MA 02126-2713

Phone

(617) 534-9172

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1043370968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MASSACHUSETTS AVENUE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-534-4212",
            "fax_number": "617-534-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262713",
            "telephone_number": "617-534-9172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Gove St",
            "address_purpose": "LOCATION",
            "city": "East Boston",
            "state": "MA",
            "postal_code": "021281920",
            "country_code": "US",
            "telephone_number": "617-568-5800",
            "fax_number": "617-568-4756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "PHILLIPE",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randal W Cole, DMD
• Danielle Collins, RDH
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• Connecting Human Rights Education LLC
• Mary G. Cooney
• Michael T Correia
• Beverly Cox, LPN
• Carol Crawford, RN
• Irene Crofton, M.D.
• CVS Pharmacy Inc

• Clinical Social Worker in Mattapan, MA
• Providers in Mattapan, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.