Healthcare Provider Details

I. General information

NPI: 1295657112
Provider Name (Legal Business Name): RUTH DANIELLE CUPIDON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 LOWES WAY STE 401
LOWELL MA
01851-5019
US

IV. Provider business mailing address

59 LOWES WAY STE 401
LOWELL MA
01851-5019
US

V. Phone/Fax

Practice location:
  • Phone: 978-565-0569
  • Fax:
Mailing address:
  • Phone: 978-565-0569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: