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General NPI Number Information
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NPI Number | 1184997009
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Entity Type | Individual
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Provider Name | MAJA CUPAC LPCC, NCC
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Gender | Female
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 1100 E MARKET ST
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City | LOUISVILLE
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State | KY
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Zip | 40206-1838
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Country | US
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Telephone | 502-596-1213
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Fax | 502-596-1400
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Provider Business Mailing Address
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Address Line | 926 WILLOW POINTE DR
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City | LOUISVILLE
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State | KY
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Zip | 40299-6604
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Country | US
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Telephone | 606-219-2380
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Fax | 502-331-6062
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | KY-1116
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License Number State | KY
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