Individual
KEITH COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPA
Contact information
Practice address
521 N BRIGHTLEAF BLVD, JOHNSTON COUNTY MENTAL HEALTH CENTER, SMITHFIELD, NC 27577-4407
(919) 989-5500
(919) 989-5532
Mailing address
PO BOX 411, JOHNSTON COUNTY MENTAL HEALTH CENTER, SMITHFIELD, NC 27577-0411
(919) 989-5500
(919) 989-5532
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1620
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107313
—
NC
Enumeration date
08/29/2006
Last updated
04/20/2008
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