Provider Demographics
NPI:1013735117
Name:LOPEZ, MARIA (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 SCHOOLVIEW LN
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-2001
Mailing Address - Country:US
Mailing Address - Phone:610-212-4020
Mailing Address - Fax:
Practice Address - Street 1:77 W BALTIMORE PIKE STE 100A
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5637
Practice Address - Country:US
Practice Address - Phone:610-717-5299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017658101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health