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NPI Code Detail

MEDICARE: LORRAINE RAE COPENHAVER LSW

MEDICARE: LORRAINE RAE COPENHAVER LSW
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
1104100000XSocial WorkerSW127791PA

General Provider Information

NPI Number : 1538486394
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORRAINE RAE COPENHAVER LSW
Provider Business Mailing Address
First Line : 2907 PLEASANT VALLEY BLVD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4305
Country : US
Telephone Number : 814-943-8164
Fax Number :
Provider Business Practice Location Address
First Line : 2907 PLEASANT VALLEY BLVD
Second Line :
City : ALTOONA
State : PA
Zip : 16602-4305
Country : US
Telephone Number : 814-943-8164
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2010
Last Update Date : 02/02/2026

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Directions to “ LORRAINE RAE COPENHAVER LSW” Practice Location

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