Provider Demographics
NPI:1366142143
Name:COPELAND, RACHEL (LPC, M ED)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:COPELAND
Suffix:
Gender:F
Credentials:LPC, M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11531 PINE CONE CT
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-2239
Mailing Address - Country:US
Mailing Address - Phone:703-606-2493
Mailing Address - Fax:
Practice Address - Street 1:11531 PINE CONE CT
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-2239
Practice Address - Country:US
Practice Address - Phone:703-606-2493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0704015082101YP2500X
VA0704015082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional