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NPI Code Detail

MEDICARE: ASHLEY SIERRA COPEN MSW, LICSW

MEDICARE: ASHLEY SIERRA COPEN MSW, LICSW
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
11041C0700XClinical Social WorkerDP00945240WV
2104100000XSocial WorkerDP00945240WV

General Provider Information

NPI Number : 1841806510
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY SIERRA COPEN MSW, LICSW
Provider Business Mailing Address
First Line : 104 ALEX LN
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-2952
Country : US
Telephone Number : 304-734-2040
Fax Number : 304-734-2047
Provider Business Practice Location Address
First Line : 303 OHIO AVE
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-2212
Country : US
Telephone Number : 681-205-8720
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2020
Last Update Date : 09/03/2024

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