Provider Demographics
NPI:1962784959
Name:COPLEY, JUDITH MCCRONE (LICSW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:MCCRONE
Last Name:COPLEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-2532
Mailing Address - Country:US
Mailing Address - Phone:508-238-0797
Mailing Address - Fax:815-642-9633
Practice Address - Street 1:2 LONGVIEW DR
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-2532
Practice Address - Country:US
Practice Address - Phone:508-238-0797
Practice Address - Fax:815-642-9633
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10218751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical