Active NPI
Evelyn Koppel, MSW LCSW
- Social Worker
- Blackwood, NJ
National Provider Identifier
1700876828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SC00378
- Practice address
- 1510 Blackwood Clementon Rd
Blackwood, NJ 08012-4626 - Phone
- (856) 401-0557
- Fax
- (610) 664-1007
- NPI assigned
- Oct 28, 2005
- Sex
- Female
- Sole proprietor
- No
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 | 44SC00378 | NJ | Primary |
Addresses
Primary practice location
1510 Blackwood Clementon Rd
Blackwood, NJ 08012-4626
Mailing address
110 Pencoyo Ave
Bala Cynwyd, PA 19004
Phone (856) 401-0557
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 |
|---|---|---|---|
| 44SC00378 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1700876828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 PENCOYO AVE",
"city": "BALA CYNWYD",
"state": "PA",
"postal_code": "19004",
"telephone_number": "856-401-0557",
"fax_number": "610-664-1007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 BLACKWOOD CLEMENTON RD",
"city": "BLACKWOOD",
"state": "NJ",
"postal_code": "080124626",
"telephone_number": "856-401-0557",
"fax_number": "610-664-1007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPPEL",
"first_name": "EVELYN",
"name_prefix": "Ms.",
"credential": "MSW LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-28",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SC00378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blackwood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.