Active NPI
Crystal Kim Copeland, LMSW
- Social Worker
- Whitesboro, NY
National Provider Identifier
1558020461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 109837-01
- Practice address
- 8658 Aitken Ave
Whitesboro, NY 13492-2609 - Phone
- (315) 570-5187
- NPI assigned
- Dec 8, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 109837-01 | NY | Primary |
Addresses
Primary practice location
8658 Aitken Ave
Whitesboro, NY 13492-2609
Mailing address
1026 Ontario St
Utica, NY 13501-2744
Phone (315) 570-5187
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109837-01 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1558020461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1026 ONTARIO ST",
"city": "UTICA",
"state": "NY",
"postal_code": "135012744",
"telephone_number": "315-570-5187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8658 AITKEN AVE",
"city": "WHITESBORO",
"state": "NY",
"postal_code": "134922609",
"telephone_number": "315-570-5187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPELAND",
"first_name": "CRYSTAL",
"middle_name": "KIM",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-08",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "109837-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whitesboro, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.