Active NPI
Larry Copp, M.S., CADC
- Counselor
- Maryville, IL
National Provider Identifier
1750740544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 20037
- Practice address
- 2148 Vadalabene Dr
Maryville, IL 62062-5632 - Phone
- (618) 288-3100
- Fax
- (618) 288-2278
- NPI assigned
- Feb 22, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 20037 | IL | Primary |
Addresses
Primary practice location
2148 Vadalabene Dr
Maryville, IL 62062-5632
Mailing address
2148 Vadalabene Dr
Maryville, IL 62062-5632
Phone (618) 288-3100
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20037 | IL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456099200000",
"number": "1750740544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2148 VADALABENE DR",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620625632",
"telephone_number": "618-288-3100",
"fax_number": "618-288-2278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2148 VADALABENE DR",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620625632",
"telephone_number": "618-288-3100",
"fax_number": "618-288-2278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPP",
"first_name": "LARRY",
"name_prefix": "Mr.",
"credential": "M.S., CADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-22",
"last_updated": "2016-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "20037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.