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General NPI Number Information
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NPI Number | 1720377757
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Entity Type | Organization
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Legal Business Name | LIDIA KUPIEC LMSW
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 178 BRADLEY RD
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City | SCARSDALE
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State | NY
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Zip | 10583-6343
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Country | US
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Telephone | 914-574-5075
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Fax |
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Provider Business Mailing Address
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Address Line | 178 BRADLEY RD
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City | SCARSDALE
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State | NY
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Zip | 10583-6343
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Country | US
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Telephone | 914-574-5075
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | MS. LIDIA KUPIEC
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Credential | LMSW
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Telephone | 914-574-5075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 078510-1
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License Number State | NY
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