NPIMap

Individual provider Active NPI

Jason Alexander Kopen, LCSW

  • Clinical Social Worker
  • Black Hawk, CO
National Provider Identifier
1598929952
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
647 Issued in CO
Practice address
51 Lynnwood LN
Black Hawk, CO 80422-4545
Phone
(303) 642-3597
NPI assigned
Jul 15, 2008
Last updated
Jul 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 647 CO Primary

Addresses

Primary practice location

51 Lynnwood LN
Black Hawk, CO 80422-4545

Mailing address

51 Lynnwood LN
Black Hawk, CO 80422-4545
Phone (303) 642-3597

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memory Bridging Incorporated Past Accepting new patients
Rementis Health Group LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1598929952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 LYNNWOOD LN",
            "city": "BLACK HAWK",
            "state": "CO",
            "postal_code": "804224545",
            "telephone_number": "303-642-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 LYNNWOOD LN",
            "city": "BLACK HAWK",
            "state": "CO",
            "postal_code": "804224545",
            "telephone_number": "303-642-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPEN",
        "first_name": "JASON",
        "middle_name": "ALEXANDER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Black Hawk, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.