Provider Demographics
NPI:1225206790
Name:PUPA, DAVID A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:PUPA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2164 HIGHWAY 35
Mailing Address - Street 2:STE 6
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1013
Mailing Address - Country:US
Mailing Address - Phone:732-256-4940
Mailing Address - Fax:732-223-0388
Practice Address - Street 1:617 UNION AVE
Practice Address - Street 2:BUILDING 3 SUITE 13
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730-1838
Practice Address - Country:US
Practice Address - Phone:732-256-4940
Practice Address - Fax:732-223-0388
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053354001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical