Provider Demographics
NPI:1922627264
Name:LOPEZ, LINDA (MA LPCS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MA LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N I 35
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5226
Mailing Address - Country:US
Mailing Address - Phone:214-530-0021
Mailing Address - Fax:214-530-0021
Practice Address - Street 1:15103 MASON RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6458
Practice Address - Country:US
Practice Address - Phone:832-662-5096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73506101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional