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Individual

JILISSA COPELAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
552 VALE PARK RD STE A, VALPARAISO, IN 46385-2508
(219) 246-8873
Mailing address
679 CROSS MEADOWS DR, VALPARAISO, IN 46385-8847
(219) 246-8873

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary
34008560A
IN

Other

Enumeration date
10/23/2015
Last updated
03/26/2025
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