Provider Demographics
NPI:1245404904
Name:LOPEZ, MARIA ELENA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ELENA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 FOUNTAIN PLAZA BLVD.
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8031
Mailing Address - Country:US
Mailing Address - Phone:956-316-2224
Mailing Address - Fax:956-316-2224
Practice Address - Street 1:2715 W. TRENTON RD.
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3433
Practice Address - Country:US
Practice Address - Phone:956-683-1155
Practice Address - Fax:956-683-1188
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32660104100000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32660OtherSOCIAL WORK EXAMINERS