Provider Demographics
NPI:1720282577
Name:POPYK, MICHEL L (MSW)
Entity type:Individual
Prefix:MS
First Name:MICHEL
Middle Name:L
Last Name:POPYK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:KIWI
Other - Middle Name:
Other - Last Name:POPYK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:108 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-4402
Mailing Address - Country:US
Mailing Address - Phone:660-827-4449
Mailing Address - Fax:660-827-6489
Practice Address - Street 1:108 E 5TH ST
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-4402
Practice Address - Country:US
Practice Address - Phone:660-827-4449
Practice Address - Fax:660-827-6489
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010040611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical