Provider Demographics
NPI:1528573300
Name:RUPARD, TABITHA MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:MICHELLE
Last Name:RUPARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:MICHELLE
Other - Last Name:HIPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:607 AQUEDUCT DR
Mailing Address - Street 2:
Mailing Address - City:SEAGOVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75159-1805
Mailing Address - Country:US
Mailing Address - Phone:972-369-6851
Mailing Address - Fax:
Practice Address - Street 1:607 AQUEDUCT DR
Practice Address - Street 2:
Practice Address - City:SEAGOVILLE
Practice Address - State:TX
Practice Address - Zip Code:75159-1805
Practice Address - Country:US
Practice Address - Phone:972-369-6851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-03
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74498101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health