Provider Demographics
NPI:1134186075
Name:CHUPIK, LINDA (LMSW, LMFT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CHUPIK
Suffix:
Gender:F
Credentials:LMSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1108
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76503-1108
Mailing Address - Country:US
Mailing Address - Phone:254-773-4022
Mailing Address - Fax:254-773-0919
Practice Address - Street 1:3010 SCOTT BLVD
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-6803
Practice Address - Country:US
Practice Address - Phone:254-773-4022
Practice Address - Fax:254-773-0919
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09870101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F0466Medicare ID - Type UnspecifiedMEDICARE