MEDICARE: MR. JEFFREY JARED CHUPIK LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	74285	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	74285	OTHER	TX	LPC

General Provider Information

NPI Number	:	1306462361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY JARED CHUPIK LPC

Provider Business Mailing Address
First Line	:	PO BOX 35
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76503-0035
Country	:	US
Telephone Number	:	254-624-6761
Fax Number	:

Provider Business Practice Location Address
First Line	:	1023 CANYON CREEK DR STE 100
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-3278
Country	:	US
Telephone Number	:	254-624-6761
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2020
Last Update Date	:	05/29/2026

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