Provider Demographics
NPI:1831402601
Name:LOPEZ, RAMON ROBERTO (LPC)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:ROBERTO
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4919 JAMESTOWN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3228
Mailing Address - Country:US
Mailing Address - Phone:225-924-6621
Mailing Address - Fax:225-924-6627
Practice Address - Street 1:4919 JAMESTOWN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3228
Practice Address - Country:US
Practice Address - Phone:225-924-6621
Practice Address - Fax:225-924-6627
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4075101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health