Individual
JORDAN PANGALLO-KOPROWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, LICDC, LPC
Contact information
Practice address
111 S BEDFORD ST STE 205, BURLINGTON, MA 01803-5145
(888) 858-1723
Mailing address
446 MORGAN ST, CINCINNATI, OH 45206-2348
(513) 834-0763
(513) 873-1567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161566
OH
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
E.1700245
OH
Other
Enumeration date
01/30/2017
Last updated
12/10/2024
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