MEDICARE: DAWN ANNE COOPERSTEIN LCSW

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	1041C0700X	Clinical Social Worker	0904009338	VA
2	1041C0700X	Clinical Social Worker	18532	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0904009338	OTHER	VA	LCSW LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	18532	OTHER	AZ	LCSW LICENSE

General Provider Information

NPI Number	:	1245692508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN ANNE COOPERSTEIN LCSW

Provider Business Mailing Address
First Line	:	9555 E SHILOH ST APT 5104
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85748-3246
Country	:	US
Telephone Number	:	520-462-8559
Fax Number	:	520-336-9707

Provider Business Practice Location Address
First Line	:	9555 E SHILOH ST APT 5104
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85748-3246
Country	:	US
Telephone Number	:	520-462-8559
Fax Number	:	520-336-9707

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

Provider Enumeration Date	:	03/25/2016
Last Update Date	:	07/28/2023

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