MEDICARE: TABITIA ALICIA COPELAND BSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1225996283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TABITIA ALICIA COPELAND BSW

Provider Business Mailing Address
First Line	:	1663 MCCLELLAND AVE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30344-1613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 SOUTHLAND CIR NW STE H
Second Line	:	#339
City	:	ATLANTA
State	:	GA
Zip	:	30318-3669
Country	:	US
Telephone Number	:	404-786-0006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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Directions to “ TABITIA ALICIA COPELAND BSW” Practice Location

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