Organization
COPPERSTONE DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA KAY INGRAM (EXECUTIVE DIRECTOR)
(712) 899-0763
Entity
Organization
Contact information
Practice address
1309 PIERCE STREET, SIOUX CITY, IA 51105
(712) 899-0763
Mailing address
1309 PIERCE ST, SIOUX CITY, IA 51105-1422
(712) 899-0763
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/07/2024
Last updated
12/11/2025
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