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Individual

THERESA M HOPPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8727
(606) 523-8521
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4900
(502) 489-5751

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
252484
KY
1041C0700X
Clinical Social Worker
LCSW-185
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
307090
BS OF WY
WY
05
7100450820
KY
01
MH63
WINHEALTH PARTNERS
WY
Enumeration date
12/01/2005
Last updated
07/16/2019
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