Healthcare Provider Details

I. General information

NPI: 1780257840
Provider Name (Legal Business Name): ATUPELE MSHANA LPC - ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2021
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W KAUFMAN ST
ROCKWALL TX
75087-3032
US

IV. Provider business mailing address

713 DASHWOOD DR
PRINCETON TX
75407-5661
US

V. Phone/Fax

Practice location:
  • Phone: 972-693-4293
  • Fax:
Mailing address:
  • Phone: 214-604-1726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number98939
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: