Provider Demographics
NPI:1275041352
Name:LOPEZ, ANAYUREIDYS (LMHC)
Entity Type:Individual
Prefix:
First Name:ANAYUREIDYS
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NW 87TH AVE APT C223
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4529
Mailing Address - Country:US
Mailing Address - Phone:786-349-8371
Mailing Address - Fax:
Practice Address - Street 1:30 NW 87TH AVE APT C223
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4529
Practice Address - Country:US
Practice Address - Phone:786-349-8371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-11
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician