Provider Demographics
NPI:1447032537
Name:ROPP, COURTNEY KAYE (LSW)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:KAYE
Last Name:ROPP
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:KAYE
Other - Last Name:ROPP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:309 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46528-3419
Mailing Address - Country:US
Mailing Address - Phone:541-220-8359
Mailing Address - Fax:
Practice Address - Street 1:309 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46528-3419
Practice Address - Country:US
Practice Address - Phone:541-220-8359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33010695A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker