Provider Demographics
NPI:1386707842
Name:MAUPIN, EDWIN PAUL (MA LMHP LIMHP CPC)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:PAUL
Last Name:MAUPIN
Suffix:
Gender:M
Credentials:MA LMHP LIMHP CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:OGALLALA
Mailing Address - State:NE
Mailing Address - Zip Code:69153-0297
Mailing Address - Country:US
Mailing Address - Phone:308-284-6519
Mailing Address - Fax:308-284-6513
Practice Address - Street 1:103 E 10TH ST
Practice Address - Street 2:
Practice Address - City:OGALLALA
Practice Address - State:NE
Practice Address - Zip Code:69153-1442
Practice Address - Country:US
Practice Address - Phone:308-284-6519
Practice Address - Fax:308-284-6513
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE970101Y00000X
NE1570101YM0800X
NE1047101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
84154OtherBLUE CROSS
NE47083176426Medicaid
006336OtherRAIL ROAD