Provider Demographics
NPI:1326847112
Name:COPELAND, CRYSTAL (LPC)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:
Last Name:COPELAND
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 SMITH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2519
Mailing Address - Country:US
Mailing Address - Phone:252-455-3501
Mailing Address - Fax:
Practice Address - Street 1:2117 SMITH AVE STE B
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2519
Practice Address - Country:US
Practice Address - Phone:757-547-9007
Practice Address - Fax:757-786-2805
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
VA0701014612101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional