Mandy Lopez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-09467 Issued in NM

Practice address

6330 Riverside Plaza LN NW Ste 260
Albuquerque, NM 87120-2160

Phone

(505) 226-2839

NPI assigned

Feb 10, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Cottonwood Counseling, LLC

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1518453968
  NPD (past)

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1053735100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 BLUE MOON DR NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871444145",
            "telephone_number": "505-901-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 RIVERSIDE PLAZA LN NW STE 260",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871202160",
            "telephone_number": "505-226-2839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MANDY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA QH#",
            "identifier": "13583510",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05852820",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Paulette Lopez, M.S., LMHC
• Lizbeth Lopez
• Louise Lopez
• Lucille Lopez, PT
• Lucille D. Lopez, LISW
• Margaux Lopez
• Mark Lopez
• Mark Dominic Lopez, NP
• Matthew Lopez
• Melissa Lopez

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.