Ian Mitchell Kopp, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

29816 Issued in MN

Practice address

435 University Ave E
Saint Paul, MN 55130-4495

Phone

(651) 789-7634

Fax

(651) 225-0882

NPI assigned

Apr 14, 2025

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1093500480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551304495",
            "telephone_number": "651-789-7634",
            "fax_number": "651-225-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551304495",
            "telephone_number": "651-789-7634",
            "fax_number": "651-225-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPP",
        "first_name": "IAN",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Early Koop, MD
• Hannah Rachel Kopel
• Elizabeth Kopf, MA CCC-SLP
• Richard A Kopher, MD
• Leslie A Kopietz, MD
• Josie Jean Fink Koppen, MS, CCC-SLP
• Raechel Grace Koppen, MPH, PA-C
• Ashley Koran, RNA
• Harish Koratkar, BDS, MS
• Eric J Korbach, MD

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.