Coppola, Tara Anne
Coppola, Tara Anne is an individual health care provider with primary practice located at 4006 Holcomb Bridge Rd Ste 210 , Peachtree Corners GA 30092-1814. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Coppola, Tara Anne can be contacted via phone (678) 444-4505.Contact Information
Primary practice address
4006 Holcomb Bridge Rd Ste 210
Peachtree Corners GA 30092-1814
Phone: (678) 444-4505
Fax: (678) 606-9316
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW003058 | Georgia |
Profile Details
| NPI number | 1952409294 |
|---|---|
| LBN Legal business name | Coppola, Tara Anne |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Nov 6th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952409294 | NPPES |
| Georgia | MEDICAID | 233399379A |
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