Provider Demographics
NPI:1053637785
Name:KULPINSKI, LISA MARIE (PHD)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:KULPINSKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LYMAN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-3709
Mailing Address - Country:US
Mailing Address - Phone:801-556-1870
Mailing Address - Fax:
Practice Address - Street 1:27 CHARLES ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1664
Practice Address - Country:US
Practice Address - Phone:801-556-1870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9168103TC1900X
UT6139302-2501103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling