Provider Demographics
NPI:1235986274
Name:KUPRIANCZYK EMILY
Entity type:Organization
Organization Name:KUPRIANCZYK EMILY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUPRIANCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:812-267-8465
Mailing Address - Street 1:20 CARLOTIA DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-5229
Mailing Address - Country:US
Mailing Address - Phone:812-267-8465
Mailing Address - Fax:
Practice Address - Street 1:1400 MAIN ST UNIT 139
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-3110
Practice Address - Country:US
Practice Address - Phone:812-267-8465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty