Individual
KELLY M KOPATICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
OLD TOWNE COUNSELING OF NEWBURGH, LLC, 4333 OLD STATE ROAD 261, NEWBURGH, IN 47630-2655
(507) 491-8887
Mailing address
4333 OLD STATE RD 261, NEWBURGH, IN 47630-2655
(507) 491-8887
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
34008915A
IN
Other
Enumeration date
05/17/2016
Last updated
12/31/2020
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