Nancy Jean Copeland, PHD

Individual provider Active NPI Clinical Psychologist · Mountaintop, PA

NPI 1376590216 · NPPES record last updated Dec 6, 2011

Key facts

NPI
1376590216
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PS008628L (PA)
Practice address
359 S Mountain Blvd
Ste C-2
Mountaintop, PA 18707-1984
Phone
(570) 403-5080
Fax
(570) 403-5079
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120117000497 PA Practitioner - Clinical Psychologist 3971770843 Practice locations: Mountain Top, PA

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS008628L PA Yes

Addresses

Primary practice location

359 S Mountain Blvd
Ste C-2
Mountaintop, PA 18707-1984

Mailing address

359 S Mountain Blvd
Ste C-2
Mountaintop, PA 18707-1984
Phone (570) 403-5080

Other identifiers

IdentifierTypeStateIssuer
C0761126OtherPABLUE CROSS SHIELD
2104527OtherCIGNA

Other providers in Mountaintop, PA

All providers in Mountaintop, PA · Clinical Psychologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.