Provider Demographics
NPI:1992212054
Name:COPPAGE, JOEL CLAYTON (LICSW-S)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:CLAYTON
Last Name:COPPAGE
Suffix:
Gender:M
Credentials:LICSW-S
Other - Prefix:MR
Other - First Name:CLAY
Other - Middle Name:
Other - Last Name:COPPAGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:701 WARD AVE NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3659
Mailing Address - Country:US
Mailing Address - Phone:256-676-3507
Mailing Address - Fax:877-646-8285
Practice Address - Street 1:701 WARD AVE NE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3659
Practice Address - Country:US
Practice Address - Phone:256-676-3507
Practice Address - Fax:877-646-8285
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4314G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker