Individual provider Active NPI

Rosita Lopez, MA LLP

  • Social Worker
  • Canton, MI
National Provider Identifier
1164585303
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6301010116 Issued in MI
Practice address
6223 N Canton Center Rd
Suite 210
Canton, MI 48187-2696
Phone
(734) 737-1200
Fax
(734) 737-1205
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6301010116 MI Primary

Addresses

Primary practice location

6223 N Canton Center Rd
Suite 210
Canton, MI 48187-2696

Mailing address

614 Ravencrest LN
Westland, MI 48185-5002
Phone (734) 737-1200

Other identifiers 1

IdentifierTypeStateIssuer
11543739OtherMICAQH

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6301010116MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164585303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 RAVENCREST LN",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481855002",
            "telephone_number": "734-737-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6223 N CANTON CENTER RD",
            "address_2": "SUITE 210",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872696",
            "telephone_number": "734-737-1200",
            "fax_number": "734-737-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ROSITA",
        "name_prefix": "Ms.",
        "credential": "MA LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6301010116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11543739",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.