Provider Demographics
NPI:1598376592
Name:UPAL, BUSHRA (LPC)
Entity Type:Individual
Prefix:
First Name:BUSHRA
Middle Name:
Last Name:UPAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2294 SCHOOL VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ASBURY
Mailing Address - State:IA
Mailing Address - Zip Code:52002-8220
Mailing Address - Country:US
Mailing Address - Phone:814-572-4356
Mailing Address - Fax:
Practice Address - Street 1:2000 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-5099
Practice Address - Country:US
Practice Address - Phone:563-589-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012259101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional