Provider Demographics
NPI:1528649019
Name:KOPACK, MEGAN (MA, LPCC, LPC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:KOPACK
Suffix:
Gender:F
Credentials:MA, LPCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11438 LEBANON RD UNIT H
Mailing Address - Street 2:
Mailing Address - City:SHARONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45241-6201
Mailing Address - Country:US
Mailing Address - Phone:513-400-5788
Mailing Address - Fax:
Practice Address - Street 1:11438 LEBANON RD UNIT H
Practice Address - Street 2:
Practice Address - City:SHARONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45241-6201
Practice Address - Country:US
Practice Address - Phone:513-400-5788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012866101YM0800X
OHE.2303696101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health