Jilissa Copeland, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008560A Issued in IN

Practice address

552 Vale Park Rd Ste a
Valparaiso, IN 46385-2508

Phone

(219) 246-8873

NPI assigned

Oct 23, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 28, 2022 through Jan 28, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bloom Counseling LLC

  • Clinical Social Worker
  • Valparaiso, IN
  • NPI 1275353450
  NPD Authorized official
• Evansville Treatment Center, LLC

  • Methadone Clinic
  • Evansville, IN
  • NPI 1194878587
  NPD (past)

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1154793669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 CROSS MEADOWS DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463858847",
            "telephone_number": "219-246-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 VALE PARK RD STE A",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463852508",
            "telephone_number": "219-246-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "JILISSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-23",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008560A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Allen Cook, CADAC III
• Charles Cooper, DNP CRNA
• Jac Alan Cooper Sr., M.D.
• Latonya R Cooper, LCSW
• Stewart E. Cooper, PHD
• Adam Laurence Cordray, DO
• Corner Sun Wellness, LLC
• Amanda C Cornett, LMHCA
• Margaret Cornett
• Alan Edward Corns, DDS

• Clinical Social Worker in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.