Provider Demographics
NPI:1003500471
Name:LUPKA, SARAH VIRGINIA (MAC, PLPC, LCMHC-A)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:VIRGINIA
Last Name:LUPKA
Suffix:
Gender:F
Credentials:MAC, PLPC, LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 CARMEL EXECUTIVE PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4207
Mailing Address - Country:US
Mailing Address - Phone:980-800-4323
Mailing Address - Fax:
Practice Address - Street 1:7301 CARMEL EXECUTIVE PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4207
Practice Address - Country:US
Practice Address - Phone:980-800-4323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023023586101YM0800X
NCA20292101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health