Individual provider Active NPI

Victoria Lopez, LPC

  • Mental Health Counselor
  • Fort Worth, TX
National Provider Identifier
1013644715
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
81712 Issued in TX
Practice address
505 Pecan St Ste 102
Fort Worth, TX 76102-4079
Phone
(817) 608-6701
NPI assigned
Aug 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 81712 TX Primary

Addresses

Primary practice location

505 Pecan St Ste 102
Fort Worth, TX 76102-4079

Mailing address

505 Pecan St Ste 102
Fort Worth, TX 76102-4079

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@thebravefight.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
81712TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Brave Fight, LLC CurrentSince Aug 28, 2022 Accepting new patients

Locations

505 Pecan St
Ste 102
Fort Worth, TX 76102
Phone (817) 381-6991

500 E 4th St
Ste 250
Fort Worth, TX 76102
Phone (817) 381-6991

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1013644715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PECAN ST STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PECAN ST STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024079",
            "telephone_number": "817-608-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "VICTORIA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "81712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@thebravefight.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "505 Pecan St Ste 102",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761024079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.