MEDICARE: MS. LINDA LOU CHOPLIN MED, LISAC, NBCC, MC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	40152	SC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	10274	AZ
3	101YM0800X	Mental Health Counselor	40152	SC

General Provider Information

NPI Number	:	1033366687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA LOU CHOPLIN MED, LISAC, NBCC, MC

Provider Business Mailing Address
First Line	:	3530 E INDIAN SCHOOL RD STE 5
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5141
Country	:	US
Telephone Number	:	602-224-5499
Fax Number	:	602-274-5791

Provider Business Practice Location Address
First Line	:	3530 E INDIAN SCHOOL RD STE 5
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5141
Country	:	US
Telephone Number	:	602-224-5499
Fax Number	:	602-274-5791

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2008
Last Update Date	:	08/26/2008

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