Raymond Coppock, CDCII, BHAII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1331 Issued in AK

Practice address

333 Shore Ave
Kotzebue, AK 99752-9800

Phone

(907) 442-7640

Fax

(907) 442-7749

NPI assigned

May 7, 2007

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1972716959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 256",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SHORE AVE",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997529800",
            "telephone_number": "907-442-7640",
            "fax_number": "907-442-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOCK",
        "first_name": "RAYMOND",
        "name_prefix": "Mr.",
        "credential": "CDCII, BHAII",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "AK",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AK",
            "license": "1331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• C Brett Connor, LMT
• Ana Lilia Contreras, RDH
• Louise Sarah Conwell, CARE COORDINATOR
• Sandra Lee Cook, CNM
• Joseph E Copeland, M.D.
• Jason Matthew Cubbin, LPC
• Zazell Staheli Cummings, DDS
• Micheline Curtis, COMMUNITY HEALTHAIDE
• Loretta Vera Custer
• Srikanth Rao Dakoji, M.D.,PH.D.

• Addiction (Substance Use Disorder) Counselor in Kotzebue, AK
• Providers in Kotzebue, AK by specialty
• Addiction (Substance Use Disorder) Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.