Provider Demographics
NPI:1881933489
Name:LUPILOFF, ERICA (MA L L P PSY)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LUPILOFF
Suffix:
Gender:F
Credentials:MA L L P PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 520
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3407
Mailing Address - Country:US
Mailing Address - Phone:248-646-6659
Mailing Address - Fax:
Practice Address - Street 1:2075 W BIG BEAVER RD
Practice Address - Street 2:SUITE 520
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3407
Practice Address - Country:US
Practice Address - Phone:248-646-6659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011192101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional