Individual provider Active NPI

Louise Raphaela Lopez, PSY.D.

  • Clinical Psychologist
  • Fort Lauderdale, FL
National Provider Identifier
1174761787
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7869 Issued in FL
Practice address
1760 NE 13TH St
Fort Lauderdale, FL 33304-1846
Phone
(561) 351-6232
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY7869 FL Primary

Addresses

Primary practice location

1760 NE 13TH St
Fort Lauderdale, FL 33304-1846

Mailing address

1760 NE 13TH St
Fort Lauderdale, FL 33304-1846
Phone (561) 351-6232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090306000603 FL Practitioner - Clinical Psychologist 3971669433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3600 Washington St
Hollywood, FL 33021-8216
Phone (954) 966-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY7869FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Clinical & Forensic Psychology Inc Clinical CurrentSince Feb 5, 2009 Accepting new patients
Louise R. Lopez, PSYD, PA Clinical CurrentSince May 19, 2010 Accepting new patients

Locations

2881 E Oakland Park Blvd
Ste 103
Ft Lauderdale, FL 33306
Phone (561) 351-6232

3600 Washington St
Hollywood, FL 33021
Phone (954) 265-4461

Organizations & group practices 2

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": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1174761787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 NE 13TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041846",
            "telephone_number": "561-351-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 NE 13TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041846",
            "telephone_number": "561-351-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "LOUISE",
        "middle_name": "RAPHAELA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.