Camilla Renee Lopez, MSW

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3404 N Lecanto Hwy Ste D
Beverly Hills, FL 34465-3569

Phone

(352) 419-4856

Fax

(352) 464-6300

NPI assigned

May 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1093454191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 N LECANTO HWY STE D",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344653569",
            "telephone_number": "352-419-4856",
            "fax_number": "352-464-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 N LECANTO HWY STE D",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344653569",
            "telephone_number": "352-419-4856",
            "fax_number": "352-464-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "CAMILLA",
        "middle_name": "RENEE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clopez@impactyourlifecc.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "3404 N Lecanto Hwy Ste D",
            "city": "Beverly Hills",
            "state": "FL",
            "country_code": "US",
            "postal_code": "344653569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Counselor in Beverly Hills, FL
• Providers in Beverly Hills, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.