Provider Demographics
NPI:1386262632
Name:COPELAND, RILEY JORDAN (LCSW)
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:JORDAN
Last Name:COPELAND
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 1:1607 NW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-3413
Mailing Address - Country:US
Mailing Address - Phone:580-341-0823
Mailing Address - Fax:
Practice Address - Street 1:13101 MEMORIAL SPRINGS CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-2228
Practice Address - Country:US
Practice Address - Phone:405-438-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK88741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical