Provider Demographics
NPI:1588789689
Name:COPELAND, POPPY CARLSON (MA LPC)
Entity type:Individual
Prefix:MS
First Name:POPPY
Middle Name:CARLSON
Last Name:COPELAND
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2541 BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3721
Mailing Address - Country:US
Mailing Address - Phone:303-447-8313
Mailing Address - Fax:303-447-2318
Practice Address - Street 1:2541 BLUFF ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3721
Practice Address - Country:US
Practice Address - Phone:303-447-8313
Practice Address - Fax:303-447-2318
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC 740101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health