Provider Demographics
NPI:1720698236
Name:ROPPA, GINA S (LCSW)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:S
Last Name:ROPPA
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 1:1 BALDRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8233
Mailing Address - Country:US
Mailing Address - Phone:636-515-4179
Mailing Address - Fax:
Practice Address - Street 1:1 BALDRIDGE CT
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-8233
Practice Address - Country:US
Practice Address - Phone:636-515-4179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-09
Last Update Date:2020-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical