Jerry Copeland, MSW, LLMSW, CAADC,

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851108144 Issued in MI

Practice address

14799 Dix Toledo Rd
Southgate, MI 48195-2507

Phone

(734) 324-8326

Fax

(734) 324-8327

NPI assigned

Nov 17, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jcopeland1123831@direct.hfhs.org

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1891237186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507",
            "telephone_number": "734-324-8326",
            "fax_number": "313-962-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507",
            "telephone_number": "734-324-8326",
            "fax_number": "734-324-8327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "445 Ledyard St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012641",
            "country_code": "US",
            "telephone_number": "313-962-9446 x228",
            "fax_number": "313-962-6395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPELAND",
        "first_name": "JERRY",
        "credential": "MSW, LLMSW, CAADC,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-17",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851108144",
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Convenient Homehealth Care
• Sarah Cook, LLBSW
• Kathleen Erin Cooley
• Margo Cooper, LLBSW
• David Copeland, LMSW
• Caius Coretchi, MD, DMD
• Alanna Maria Coronado, BA, MS
• Cecilia Coronado
• Kelly Marie Cosgrove
• Tania Cosman

• Clinical Social Worker in Southgate, MI
• Providers in Southgate, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.