Provider Demographics
NPI:1306122130
Name:COPELAND-LUPTON, ARDEEN PATRICIA (LCSW-C)
Entity type:Individual
Prefix:
First Name:ARDEEN
Middle Name:PATRICIA
Last Name:COPELAND-LUPTON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 WEST WARD ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-3024
Mailing Address - Country:US
Mailing Address - Phone:410-286-0664
Mailing Address - Fax:410-286-2834
Practice Address - Street 1:137 MITCHELLS CHANCE ROAD
Practice Address - Street 2:SUITE 260
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2794
Practice Address - Country:US
Practice Address - Phone:410-956-5300
Practice Address - Fax:410-956-5301
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD092351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical