Provider Demographics
NPI:1902579220
Name:TUPER, LASHAWN (LPC)
Entity type:Individual
Prefix:
First Name:LASHAWN
Middle Name:
Last Name:TUPER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2126 E VICTORY DR PMB 210
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-3918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2126 E VICTORY DR
Practice Address - Street 2:PMB 210
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-3918
Practice Address - Country:US
Practice Address - Phone:912-259-8046
Practice Address - Fax:912-724-7209
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-01
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012239101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health