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NPI Code Detail

MEDICARE: CHRISTOPHER COPENHAVER

MEDICARE: CHRISTOPHER COPENHAVER
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
1101YM0800XMental Health Counselor
2106S00000XBehavior Technician
3103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT-16-24517OTHERBACB

General Provider Information

NPI Number : 1821441239
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER COPENHAVER
Provider Business Mailing Address
First Line : 7261 W CHARLESTON BLVD STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1679
Country : US
Telephone Number : 702-396-0101
Fax Number :
Provider Business Practice Location Address
First Line : 7261 W CHARLESTON BLVD STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1679
Country : US
Telephone Number : 702-396-0101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2016
Last Update Date : 12/17/2020

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Directions to “ CHRISTOPHER COPENHAVER ” Practice Location

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