Healthcare Provider Details

I. General information

NPI: 1699453944
Provider Name (Legal Business Name): RUPA PATEL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RUPA KAMBHAMPATI

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 WILD ROSE LN
MECHANICSBURG PA
17050-1666
US

IV. Provider business mailing address

23 WILD ROSE LN
MECHANICSBURG PA
17050-1666
US

V. Phone/Fax

Practice location:
  • Phone: 240-281-2710
  • Fax:
Mailing address:
  • Phone: 240-281-2710
  • 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: