Provider Demographics
NPI:1447363056
Name:KLOPP, EDWARD J (LCPC)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:J
Last Name:KLOPP
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6604 RAPID WATER WAY
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-0847
Mailing Address - Country:US
Mailing Address - Phone:410-825-2281
Mailing Address - Fax:410-825-0757
Practice Address - Street 1:1407 YORK RD
Practice Address - Street 2:SUITE309
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6097
Practice Address - Country:US
Practice Address - Phone:410-825-2281
Practice Address - Fax:410-825-0757
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1637101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT080-0026OtherCAREFIRST OF MARYLAND