Provider Demographics
NPI:1144978552
Name:LUPORI, SHAWNA L (LPC: PC012645)
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:L
Last Name:LUPORI
Suffix:
Gender:F
Credentials:LPC: PC012645
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-9303
Mailing Address - Country:US
Mailing Address - Phone:724-825-8212
Mailing Address - Fax:
Practice Address - Street 1:3830 GRANT ST
Practice Address - Street 2:
Practice Address - City:SOUTH PARK
Practice Address - State:PA
Practice Address - Zip Code:15129-9303
Practice Address - Country:US
Practice Address - Phone:724-825-8212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012645101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional