Healthcare Provider Details

I. General information

NPI: 1982399234
Provider Name (Legal Business Name): MR. CURTIS LIPNDA KUPTO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 NEW YORK AVE NE STE 110
WASHINGTON DC
20002-1849
US

IV. Provider business mailing address

8606 DELCRIS DR
MONTGOMERY VILLAGE MD
20886-4315
US

V. Phone/Fax

Practice location:
  • Phone: 202-489-0615
  • Fax:
Mailing address:
  • Phone: 830-423-9023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG200004762
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLG200004762
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: