Individual
MARY CUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC,CADC
Contact information
Practice address
250 ALPINE DR, SHELBYVILLE, KY 40065-8880
(502) 589-8600
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
(502) 589-8600
(502) 589-8771
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
166044
KY
Other
Enumeration date
03/08/2007
Last updated
07/15/2016
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