Provider Demographics
NPI:1831656271
Name:LOPEZ, MAYELA (LPC)
Entity Type:Individual
Prefix:
First Name:MAYELA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 E YANDELL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-3726
Mailing Address - Country:US
Mailing Address - Phone:915-562-1999
Mailing Address - Fax:915-562-1993
Practice Address - Street 1:2701 E YANDELL DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-3726
Practice Address - Country:US
Practice Address - Phone:915-562-1999
Practice Address - Fax:915-562-1993
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75802101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional