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General NPI Number Information
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NPI Number | 1790503936
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Entity Type | Organization
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Legal Business Name | MELANIE COPELAND CONSULTING, LLC
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Dates
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Enumeration Date | 09/27/2024
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 2074 GALISTEO ST., STE. B
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City | SANTA FE
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State | NM
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Zip | 87505
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Country | US
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Telephone | 505-424-0726
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Fax |
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Provider Business Mailing Address
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Address Line | 1704 LLANO ST STE B
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City | SANTA FE
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State | NM
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Zip | 87505-5415
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Country | US
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Telephone | 505-424-0726
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MELANIE COPELAND
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Credential | LCSW
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Telephone | 505-424-0726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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