Provider Demographics
NPI:1073869004
Name:LUPO, PENELOPE E (MS)
Entity Type:Individual
Prefix:
First Name:PENELOPE
Middle Name:E
Last Name:LUPO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CLYMER ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-4710
Mailing Address - Country:US
Mailing Address - Phone:315-730-7271
Mailing Address - Fax:
Practice Address - Street 1:4 CLYMER ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-4710
Practice Address - Country:US
Practice Address - Phone:315-730-7271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor