Roman Lopez
Individual provider Active NPI Mental Health Counselor · Independence, KS
NPI 1184511271 · NPPES record last updated Jun 20, 2025
Key facts
- NPI
- 1184511271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPC05067 (KS)
- Practice address
- 3751 W Main St
Independence, KS 67301-8446 - Phone
- (620) 331-1748
- NPI assigned
- Jun 20, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
PO Box
Suite 688
Independence, KS 67301
PO Box
Suite 688
Independence, KS 67301-0688
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250919002514 | KS | Practitioner - Mental Health Counselor | 5193229391 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC05067 | KS | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four County Mental Health Center Inc | Current |
Accepting new patients | |
| Four County Mental Health Center, Inc. | Current |
Accepting new patients |
Locations
3354 Highway 160
Independence, KS 67301
Phone (620) 331-1260
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC05067 | KS | Yes |
Addresses
Primary practice location
3751 W Main St
Independence, KS 67301-8446
Mailing address
3751 W Main St
Independence, KS 67301-8446
Phone (620) 331-1748
Other providers in Independence, KS
- Wynter Krisha
- Labette County Medical Center
- Labette County Medical Center
- Ajit Lale
- Mardie Anne Long
- Charles Lowry
- Tara Lyman
- Bobbye S. Maley
- Jennifer Marler
- Qwynn Marquez
All providers in Independence, KS · Mental Health Counselor in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.