Healthcare Provider Details

I. General information

NPI: 1568351104
Provider Name (Legal Business Name): ALLISON JANE COPECK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 KNOX CT STE 100
DAVIDSON NC
28036-0590
US

IV. Provider business mailing address

4705 UNIVERSITY DR BLDG 700
DURHAM NC
27707-3489
US

V. Phone/Fax

Practice location:
  • Phone: 704-892-5454
  • Fax: 704-892-5858
Mailing address:
  • Phone: 919-237-1337
  • Fax: 866-538-4716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC017940
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: