Provider Demographics
NPI:1699181776
Name:CHUPP, LEAH RACHELLE (LPC)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:RACHELLE
Last Name:CHUPP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:LEAH
Other - Middle Name:RACHELLE
Other - Last Name:BACA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 S DEWEY AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-3525
Mailing Address - Country:US
Mailing Address - Phone:405-328-4065
Mailing Address - Fax:
Practice Address - Street 1:401 S DEWEY AVE STE 108
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3525
Practice Address - Country:US
Practice Address - Phone:405-328-4065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OKLPC07743101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor