Provider Demographics
NPI:1932479276
Name:ZUPAN, TRICIA JEAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:JEAN
Last Name:ZUPAN
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 1:33 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2637
Mailing Address - Country:US
Mailing Address - Phone:315-624-1227
Mailing Address - Fax:
Practice Address - Street 1:33 OXFORD RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2637
Practice Address - Country:US
Practice Address - Phone:315-624-1227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73-0735901041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool