Healthcare Provider Details

I. General information

NPI: 1396682795
Provider Name (Legal Business Name): SARAH LUPINSKI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1908 JENNIE LEE DR
IDAHO FALLS ID
83404-6159
US

IV. Provider business mailing address

3065 SPRINGSTONE CIR
AMMON ID
83406-7541
US

V. Phone/Fax

Practice location:
  • Phone: 208-520-7074
  • Fax:
Mailing address:
  • Phone: 714-420-7178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: