Provider Demographics
NPI:1972848877
Name:LOPEZ, YADIRA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:YADIRA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:YADIRA
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:210 W NOLANA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2509
Mailing Address - Country:US
Mailing Address - Phone:956-664-1600
Mailing Address - Fax:956-664-1623
Practice Address - Street 1:210 W NOLANA AVE STE B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2509
Practice Address - Country:US
Practice Address - Phone:956-664-1600
Practice Address - Fax:956-664-1623
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80858101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional