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General NPI Number Information
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NPI Number | 1902911209
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Entity Type | Individual
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Provider Name | SANDRA JEAN COPLON LCSW, LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | ONE COLUMBUS CENTER SUITE 679
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462
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Country | US
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Telephone | 757-490-7801
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Fax | 757-523-0653
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Provider Business Mailing Address
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Address Line | 1 COLUMBUS CTR SUITE 679
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6722
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Country | US
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Telephone | 757-635-6093
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Fax | 757-523-0653
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0904005643
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License Number State | VA
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