Individual provider Active NPI

Lisa Upshaw Fuente

  • Developmental Therapist
  • Safety Harbor, FL
National Provider Identifier
1780987529
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
140 12TH Ave N
Safety Harbor, FL 34695-3420
Phone
(631) 561-8709
NPI assigned
Dec 17, 2010
Last updated
Aug 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Developmental Therapist 222Q00000X FL Primary

Addresses

Primary practice location

140 12TH Ave N
Safety Harbor, FL 34695-3420

Mailing address

140 12TH Ave N
Safety Harbor, FL 34695-3420
Phone (631) 561-8709

Other practice location 1

3670 Sinclair Shores Rd
Cumming, GA 30041-5411
Phone (631) 561-8709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1780987529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 12TH AVE N",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346953420",
            "telephone_number": "631-561-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 12TH AVE N",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346953420",
            "telephone_number": "631-561-8709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3670 Sinclair Shores Rd",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300415411",
            "country_code": "US",
            "telephone_number": "631-561-8709",
            "fax_number": "631-561-8709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUENTE",
        "first_name": "LISA",
        "middle_name": "UPSHAW",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-17",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.