Provider Demographics
NPI:1396624201
Name:CUPP, JAYCIE
Entity type:Individual
Prefix:
First Name:JAYCIE
Middle Name:
Last Name:CUPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 BLESSINGS WAY
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-4941
Mailing Address - Country:US
Mailing Address - Phone:615-925-9619
Mailing Address - Fax:
Practice Address - Street 1:3012 BUSINESS PARK CIR STE 700
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3191
Practice Address - Country:US
Practice Address - Phone:615-445-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor