Active NPI
Stefan Kopka
- Clinical Social Worker
- Ann Arbor, MI
National Provider Identifier
1275969750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801058474
- Practice address
- 2140 E Ellsworth Rd
Ann Arbor, MI 48108-2552 - Phone
- (734) 222-3400
- Fax
- (734) 971-2487
- NPI assigned
- Sep 17, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801058474 | MI | Primary |
Addresses
Primary practice location
2140 E Ellsworth Rd
Ann Arbor, MI 48108-2552
Mailing address
555 Towner St
Ypsilanti, MI 48198-5752
Phone (734) 544-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801058474 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407715200000",
"number": "1275969750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 TOWNER ST",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481985752",
"telephone_number": "734-544-3000",
"fax_number": "734-544-6732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 E ELLSWORTH RD",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481082552",
"telephone_number": "734-222-3400",
"fax_number": "734-971-2487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPKA",
"first_name": "STEFAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-17",
"last_updated": "2014-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801058474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.