Provider Demographics
NPI:1215815691
Name:KEPPLER, AJA COUPAL (LCSW)
Entity type:Individual
Prefix:
First Name:AJA
Middle Name:COUPAL
Last Name:KEPPLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 WAGON WHEEL DR
Mailing Address - Street 2:
Mailing Address - City:FEEDING HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:01030-1555
Mailing Address - Country:US
Mailing Address - Phone:770-855-0002
Mailing Address - Fax:
Practice Address - Street 1:58 OLD NORTH RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MA
Practice Address - Zip Code:01098-9708
Practice Address - Country:US
Practice Address - Phone:413-238-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW2141208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health