Individual
LARRY W KOPPELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
185 HOSPITAL DR, WARREN, PA 16365-4896
(814) 723-1330
(814) 723-5744
Mailing address
507 CONEWANGO AVE, WARREN, PA 16365-1501
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW013360
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
334384
BC/BS PROVIDER #
PA
Enumeration date
11/03/2006
Last updated
09/24/2009
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