Kathi L Kopacz, LCSW-C
Individual provider Active NPI Clinical Social Worker · New Market, MD
NPI 1508970302 · NPPES record last updated Sep 10, 2008
Key facts
- NPI
- 1508970302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 04259 (MD)
- Practice address
- 164 W Main St
Suite a
New Market, MD 21774-6204 - Phone
- (301) 704-3546
- Fax
- (301) 668-3076
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Tulane University School of Medicine, 1979
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
6135 Baldridge Ter
Frederick, MD 21701-5858
Phone (301) 704-3546
6135 Baldridge Terr
Frederick, MD 21701-5858
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050104000723 | MD | Practitioner - Clinical Social Worker | 2365490638 | Practice locations: Frederick, MD |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Center for Integrative Healthcare, LLC | Clinical | Past |
Accepting new patients |
| Mental Health Assoc of Frederick Cty | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 04259 | MD | Yes |
Addresses
Primary practice location
164 W Main St
Suite a
New Market, MD 21774-6204
Mailing address
6135 Baldridge Ter
Frederick, MD 21701-5858
Phone (301) 704-3546
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 216631300 | Medicaid | MD |
Other providers in New Market, MD
- Jan L Kennedy
- Ricki Kern
- Lydia Kieffer
- Kinera Foundation Inc
- Brendan Paul Koning
- Kaytlin Lapsa
- James Paul Lee
- Stacey A Lenisa
- Linganore Counseling and Wellness, LLC
- Linganore Counseling and Wellness, LLC
All providers in New Market, MD · Clinical Social Worker in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.