Individual
CARLY N LUPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
700 S ROSEMARY AVE, SUITE 204 OFC 101, WEST PALM BEACH, FL 33401
(561) 246-5063
Mailing address
700 S ROSEMARY AVE STE 204, WEST PALM BEACH, FL 33401-6310
(561) 246-5063
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW16239
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103557300
—
FL
01
—
M4MO2
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/19/2019
Last updated
08/11/2020
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