Active NPI
Jesse Lopez
- Addiction (Substance Use Disorder) Counselor
- Saint Louis, MO
National Provider Identifier
1134844103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 1 Jefferson Barracks Rd
Saint Louis, MO 63125-4181 - Phone
- (314) 894-6598
- NPI assigned
- Oct 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
1 Jefferson Barracks Rd
Saint Louis, MO 63125-4181
Mailing address
123 Shadowbrooke
Troy, IL 62294-3625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5374 | Other | MO | MISSOURI ASSOCIATE ALCOHOL DRUG COUNSELOR |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665446400000",
"number": "1134844103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 SHADOWBROOKE",
"city": "TROY",
"state": "IL",
"postal_code": "622943625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 JEFFERSON BARRACKS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631254181",
"telephone_number": "314-894-6598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "JESSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-11",
"last_updated": "2022-10-11",
"certification_date": "2022-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSOURI ASSOCIATE ALCOHOL DRUG COUNSELOR",
"identifier": "5374",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.