Provider Demographics
NPI:1467928317
Name:CARLOS LOPEZ & ASSOCIATES LLC
Entity Type:Organization
Organization Name:CARLOS LOPEZ & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MBA, LCPC, LPC,
Authorized Official - Phone:361-318-8778
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457-0307
Mailing Address - Country:US
Mailing Address - Phone:207-403-9215
Mailing Address - Fax:207-403-9344
Practice Address - Street 1:213 W. BROADWAY
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ME
Practice Address - Zip Code:04457
Practice Address - Country:US
Practice Address - Phone:207-403-9215
Practice Address - Fax:207-403-9344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty