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General NPI Number Information
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NPI Number | 1871445411
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Entity Type | Individual
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Provider Name | POLINA KOPYLOVA LMSW, LADAC II
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Gender | Female
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Dates
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Enumeration Date | 02/13/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 1000 ARDMORE ALCOA WAY APT 207
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City | LOUISVILLE
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State | TN
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Zip | 37777-3062
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Country | US
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Telephone | 803-597-0189
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 ARDMORE ALCOA WAY APT 207
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City | LOUISVILLE
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State | TN
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Zip | 37777-3062
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1683
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 15072
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License Number State | TN
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