Provider Demographics
NPI:1942526744
Name:LUPLOW, ASHLEY RYANE (LMSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RYANE
Last Name:LUPLOW
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9483 SEAGREEN DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48609-9523
Mailing Address - Country:US
Mailing Address - Phone:989-751-3860
Mailing Address - Fax:
Practice Address - Street 1:9483 SEAGREEN DR.
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48609-9523
Practice Address - Country:US
Practice Address - Phone:989-751-3860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010910261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
382143740OtherTAX ID
MI730195Medicaid