Active NPI
Gabriel Manuel Lopez Jr., LMSW
- Mental Health Counselor
- Tucson, AZ
National Provider Identifier
1265080196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LMSW-17543
- Practice address
- 4560 E Broadway Blvd Ste 223
Tucson, AZ 85711-3558 - Phone
- (520) 850-1114
- NPI assigned
- Sep 4, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LMSW-17543 | AZ | Primary |
Addresses
Primary practice location
4560 E Broadway Blvd Ste 223
Tucson, AZ 85711-3558
Mailing address
4560 E Broadway Blvd Ste 223
Tucson, AZ 85711-3558
Phone (502) 850-1114
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-17543 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567555200000",
"number": "1265080196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 E BROADWAY BLVD STE 223",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857113558",
"telephone_number": "502-850-1114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 E BROADWAY BLVD STE 223",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857113558",
"telephone_number": "520-850-1114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "GABRIEL",
"middle_name": "MANUEL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-04",
"last_updated": "2019-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LMSW-17543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.