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General NPI Number Information
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NPI Number | 1881194405
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Entity Type | Individual
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Provider Name | JASON CARL SOPKOVICH LPC LICDC
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Gender | Male
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 7801 DAY DR 29054
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City | PARMA
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State | OH
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Zip | 44129-5660
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Country | US
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Telephone | 216-650-4408
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Fax |
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Provider Business Mailing Address
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Address Line | 7801 DAY DR UNIT 29054
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City | PARMA
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State | OH
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Zip | 44129-5656
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Country | US
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Telephone | 216-323-9538
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Fax | 216-270-7347
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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 | LICDC.162769
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2506972
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C.2506972
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.2506972
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License Number State | OH
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