Provider Demographics
NPI:1306053228
Name:COPPOCK, ELIZABETH WARDWELL (LPC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:WARDWELL
Last Name:COPPOCK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2437 W DUNKELD PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3737
Mailing Address - Country:US
Mailing Address - Phone:303-667-0345
Mailing Address - Fax:303-455-1129
Practice Address - Street 1:2727 W 92ND AVE STE 100C
Practice Address - Street 2:
Practice Address - City:FEDERAL HEIGHTS
Practice Address - State:CO
Practice Address - Zip Code:80260-5269
Practice Address - Country:US
Practice Address - Phone:303-667-0345
Practice Address - Fax:303-455-1129
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC 4118101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health