Abigail Kopelman, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.010480 Issued in IL

Practice address

1580 S Milwaukee Ave Ste 430
Libertyville, IL 60048-3761

Phone

(847) 802-8199

NPI assigned

May 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Reflections Counseling and Assessment LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Libertyville, IL
  • NPI 1083455026
  NPD Authorized official
• Center for Psychology and Wellness, P.C.

  • Psychologist
  • Northbrook, IL
  • NPI 1194113357
  NPD (past)

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1629642699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 LIBERTY BELL LN",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483456",
            "telephone_number": "847-323-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 S MILWAUKEE AVE STE 430",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483761",
            "telephone_number": "847-802-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPELMAN",
        "first_name": "ABIGAIL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Koffel Medical Supply Inc
• Candia A. Koleszar, RPH
• Karyn Kolner, DPT
• Tina Kolovos, PHARMD
• Lisa Mostowfi Konz, DDS
• Clark Kopelman, MSW, ED.S., PH.D.
• Caroline Louise Koppi, M.D.
• Emily Korman
• Joan Louise Kosman, P.T.
• Andrew Kotis, DO

• Clinical Psychologist in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.