Provider Demographics
NPI:1992426118
Name:COPE, ELIZABETH (MBA, LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:COPE
Suffix:
Gender:F
Credentials:MBA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41375 240TH ST
Mailing Address - Street 2:
Mailing Address - City:ARTESIAN
Mailing Address - State:SD
Mailing Address - Zip Code:57314-6002
Mailing Address - Country:US
Mailing Address - Phone:605-933-1652
Mailing Address - Fax:
Practice Address - Street 1:41375 240TH ST
Practice Address - Street 2:
Practice Address - City:ARTESIAN
Practice Address - State:SD
Practice Address - Zip Code:57314-6002
Practice Address - Country:US
Practice Address - Phone:605-933-1652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD60091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical