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General NPI Number Information
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NPI Number | 1922661354
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Entity Type | Individual
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Provider Name | CHANTEL B. COPELAND LICSW
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Gender | Female
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 2666 COTONEASTER CT
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City | WALDORF
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State | MD
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Zip | 20601
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Country | US
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Telephone | 301-245-1339
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Fax |
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Provider Business Mailing Address
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Address Line | 2957 FESTIVAL WAY SUITE 123 #1014
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City | WALDORF
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State | MD
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Zip | 20601
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Country | US
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Telephone | 813-830-3261
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50082549
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 26945
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License Number State | MD
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