Provider Demographics
NPI:1174659288
Name:KROUPA, STEVEN E (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:KROUPA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 LUMINA PL
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8311
Mailing Address - Country:US
Mailing Address - Phone:919-552-3880
Mailing Address - Fax:
Practice Address - Street 1:153 LUMINA PL
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-8311
Practice Address - Country:US
Practice Address - Phone:919-552-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1817103TC0700X
CO1630103TC0700X
WY214103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical