Provider Demographics
NPI:1780170340
Name:CUPP, HEATHER ELIZABETH (LPC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELIZABETH
Last Name:CUPP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ELIZABETH
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:12340 JONES RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4863
Mailing Address - Country:US
Mailing Address - Phone:281-894-7222
Mailing Address - Fax:832-678-8432
Practice Address - Street 1:12340 JONES RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4863
Practice Address - Country:US
Practice Address - Phone:281-894-7222
Practice Address - Fax:832-678-8432
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76798101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX76798OtherLICENSED PROFESSIONAL COUNSELOR NUMBER