Provider Demographics
NPI:1437629003
Name:LOPUS, MARY ANN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANN
Last Name:LOPUS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 GRASMERE DR.
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001
Mailing Address - Country:US
Mailing Address - Phone:443-370-4181
Mailing Address - Fax:
Practice Address - Street 1:1212 E CHURCHVILLE RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3416
Practice Address - Country:US
Practice Address - Phone:443-370-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10840101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional