Jessica Meagan Coppage, LICSW, PIP

Individual provider Active NPI Clinical Social Worker · Birmingham, AL

NPI 1578032199 · NPPES record last updated Nov 14, 2018

Key facts

NPI
1578032199
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
1406-4111C (AL)
Practice address
700 19TH St S
Birmingham, AL 35233-1927
Phone
(205) 933-8101
NPI assigned
Nov 14, 2018
Sex
Female
Sole proprietor
No

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)
No

State licenses

LicenseStateTypeSpecialty
1406-4111CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
C2 Counseling LLC Clinical Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1406-4111C AL Yes

Addresses

Primary practice location

700 19TH St S
Birmingham, AL 35233-1927

Mailing address

804 Forest Hills CT
Alabaster, AL 35007-4523
Phone (205) 413-7657

Other providers in Birmingham, AL

All providers in Birmingham, AL · Clinical Social Worker in Alabama

Sources for this page

Verify at the official NPI Registry.