Provider Demographics
NPI:1669065686
Name:ZUPKA, ALAN (LMHC,NCC,MA)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:ZUPKA
Suffix:
Gender:M
Credentials:LMHC,NCC,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 VILLA LN
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2131
Mailing Address - Country:US
Mailing Address - Phone:407-986-2888
Mailing Address - Fax:
Practice Address - Street 1:1347 VILLA LN
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-2131
Practice Address - Country:US
Practice Address - Phone:407-986-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-20
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health