Provider Demographics
NPI:1053749820
Name:PHELPS-COPELAND, LINDSEY DALE (LCSW)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:DALE
Last Name:PHELPS-COPELAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 669
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-0669
Mailing Address - Country:US
Mailing Address - Phone:252-209-0237
Mailing Address - Fax:252-209-0197
Practice Address - Street 1:1850 NC HIGHWAY 11
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:NC
Practice Address - Zip Code:27855-9336
Practice Address - Country:US
Practice Address - Phone:252-396-0402
Practice Address - Fax:252-396-0401
Is Sole Proprietor?:No
Enumeration Date:2013-10-14
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0084191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical