Individual provider Active NPI

Lynna Ann Tupica, LCPC

  • Professional Counselor
  • Bangor, ME
National Provider Identifier
1871898627
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC4678 Issued in ME
Practice address
64 West St
Bangor, ME 04401-5809
Phone
(207) 478-8017
NPI assigned
Jan 25, 2011
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X XL3719 ME
Professional Counselor 101YP2500X CC4678 ME Primary

Addresses

Primary practice location

64 West St
Bangor, ME 04401-5809

Mailing address

PO Box 1626
Bangor, ME 04402-1626
Phone (207) 478-8017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240228001775 ME Practitioner - Mental Health Counselor 6002251154 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
XL3719MEMDCounselor
CC4678MEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Health Affiliates Maine, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

306 Rodman Rd
Auburn, ME 04210
Phone (207) 333-3278

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1871898627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1626",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021626",
            "telephone_number": "207-478-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 WEST ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015809",
            "telephone_number": "207-478-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUPICA",
        "first_name": "LYNNA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-25",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ME",
            "license": "XL3719",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC4678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.