Provider Demographics
NPI:1891942793
Name:LUPTON, PAULA MICHELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:MICHELLE
Last Name:LUPTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 W CENTRAL BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-1808
Mailing Address - Country:US
Mailing Address - Phone:407-836-8882
Mailing Address - Fax:407-836-8853
Practice Address - Street 1:823 W CENTRAL BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-1808
Practice Address - Country:US
Practice Address - Phone:407-836-8882
Practice Address - Fax:407-836-8853
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 97151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical