Individual
MR. BRUCE A. COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
122 BIRDIE DR, SUFFOLK, VA 23434-9282
(757) 478-6680
Mailing address
122 BIRDIE DR, SUFFOLK, VA 23434-9282
(757) 478-6680
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0812000377
VA
1041C0700X
Clinical Social Worker
Primary
0904003110
VA
1041S0200X
School Social Worker
0904003110
VA
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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