Shawnee M. Coppersmith, RD LDN/LD

Individual provider Active NPI Registered Dietitian · Hollidaysburg, PA

NPI 1275540478 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1275540478
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
DN003422 (PA)
Practice address
15 South Montgomery Street
Lytle Behavioral Health
Hollidaysburg, PA 16648
Phone
(814) 696-3277
Fax
(814) 695-5307
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Lytle Behavioral Health Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN003422 PA Yes

Addresses

Primary practice location

15 South Montgomery Street
Lytle Behavioral Health
Hollidaysburg, PA 16648

Mailing address

532 Walnut St
Hollidaysburg, PA 16648-1530
Phone (814) 931-3363

Other providers in Hollidaysburg, PA

All providers in Hollidaysburg, PA · Registered Dietitian in Pennsylvania

Sources for this page

Verify at the official NPI Registry.