Individual provider Active NPI

Lindsey Young Copeland, PH.D.

  • Psychologist
  • Durham, NC
National Provider Identifier
1164855011
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4772 Issued in NC
Practice address
1316 Broad St
Durham, NC 27705-3533
Phone
(919) 358-9624
Fax
(919) 908-7481
NPI assigned
Aug 14, 2013
Last updated
Nov 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 103077 NC
Psychologist 103T00000X 4772 NC Primary

Addresses

Primary practice location

1316 Broad St
Durham, NC 27705-3533

Mailing address

10828 Wilmore Dr
Raleigh, NC 27614-9191
Phone (919) 358-9624

Other names 1

  • Lindsey Elizabeth Young Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 6, 2024 through Aug 6, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4772NCMDPsychologist
103077NCMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1164855011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10828 WILMORE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276149191",
            "telephone_number": "919-358-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053533",
            "telephone_number": "919-358-9624",
            "fax_number": "919-908-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "LINDSEY",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "103077",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "YOUNG",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.