Individual
MS. LEANN MARIE HUPALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LSATP
Contact information
Practice address
1041 SHARON RD STE 203, KING WILLIAM, VA 23086-3344
(804) 398-8401
Mailing address
1041 SHARON RD STE 203, KING WILLIAM, VA 23086-3344
(804) 398-8401
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0718000295
VA
101YM0800X
Mental Health Counselor
Primary
0701005406
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701005406
STATE LIC. FROM COMM. OF VA DEPT OF HEALTH PROFESSIONS BOARD OF COUNSELING
VA
01
—
0718000295
STATE LIC. FROM COMM. OF VA DEPT OF HEALTH PROFESSIONS BOARD OF COUNSELING
VA
Enumeration date
03/08/2013
Last updated
02/06/2020
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