Provider Demographics
NPI:1114709177
Name:GUPTA, SHWETHA
Entity type:Individual
Prefix:
First Name:SHWETHA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14550 YORK RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9307
Mailing Address - Country:US
Mailing Address - Phone:443-330-7900
Mailing Address - Fax:
Practice Address - Street 1:7801 YORK RD STE 224
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7448
Practice Address - Country:US
Practice Address - Phone:410-343-9469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst