Provider Demographics
NPI:1720377757
Name:LIDIA KUPIEC LMSW
Entity Type:Organization
Organization Name:LIDIA KUPIEC LMSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUPIEC
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:914-574-5075
Mailing Address - Street 1:178 BRADLEY RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6343
Mailing Address - Country:US
Mailing Address - Phone:914-574-5075
Mailing Address - Fax:
Practice Address - Street 1:178 BRADLEY RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6343
Practice Address - Country:US
Practice Address - Phone:914-574-5075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078510-1322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children