Mr. Willard Keith Cupp Iii
PMHNP | Nurse Practitioner - Psych/Mental Health | 5+ years Exp
236 Simpson Ave, Elkhart
Indiana, 46516-4666
574-293-0052
Mr. Willard Keith Cupp Iii is a Elkhart, Indiana based nurse practitioner with 5 years of experience in Psych/Mental Health. He completed his graduation in 2020. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Mr. Willard Keith Cupp Iii is 71010753A for Psych/Mental Health in Indiana. His current practice location is 236 Simpson Ave, Elkhart. Patients can reach him at 574-293-0052. Mr. Willard Keith Cupp Iii is PMHNP with specialization in Psych/Mental Health and his NPI number (Unique professional ID assigned by NPPES) is 1265021406.
Mr. Willard Keith Cupp Iii provides a full range of primary mental health care services, including biopsychosocial assessment and diagnosis of patients with mental illness and co-occurring disorders. Treatment modalities include both medication and psychotherapeutic management. Psych/Mental Health Nurse Practitioner (PMHNP) works in a variety of settings, including inpatient, emergency and community-based mental health services.
Complete Profile:
Mr. Willard Keith Cupp Iii speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Mr. Willard Keith Cupp Iii |
| Specialization: | Psych/Mental Health Nurse Practitioner (PMHNP) |
| Gender: | Male |
| Credentials: | PMHNP |
| Experience: | 5+ years |
| Medical School Attended: | Other |
| Graduation Year: | 2020 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 236 Simpson Ave, Elkhart,
Indiana, 46516-4666 |
| Phone: | 574-293-0052 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 3173937299 |
| Enrollment ID: | I20210202001233 |
| NPI Number: | 1265021406 |
| NPI Enumeration Date: | 12 Jan, 2021 |
| NPI Last Update On: | 03 Nov, 2023 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Willard Keith Cupp Iii are as mentioned below.
| License Number | Specialization | State | Status | |
| 71010753A | Psych/Mental Health | Indiana | Primary | |
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Mr. Willard Keith Cupp Iii is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Heart City Health Center Inc (9931008380) | 17 |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Mr. Willard Keith Cupp Iii
236 Simpson Ave,
Elkhart, Indiana |
| Zip: | 46516-4666 |
| Phone Number: | 574-968-2461 |
Patients can reach Mr. Willard Keith Cupp Iii at
236 Simpson Ave, Elkhart, Indiana or can
call to book an appointment on 574-293-0052.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.