Provider Demographics
NPI:1699181776
Name:CHUPP, LEAH RACHELLE (LPC-C)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:RACHELLE
Last Name:CHUPP
Suffix:
Gender:F
Credentials:LPC-C
Other - Prefix:MS
Other - First Name:LEAH
Other - Middle Name:RACHELLE
Other - Last Name:BACA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1906 LIMESTONE ROAD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-6714
Mailing Address - Country:US
Mailing Address - Phone:405-328-4065
Mailing Address - Fax:
Practice Address - Street 1:209 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:OKEMAH
Practice Address - State:OK
Practice Address - Zip Code:74859-2618
Practice Address - Country:US
Practice Address - Phone:405-328-4065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor