Ronny Frederick Lopez Jr., CSAC, ICADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Honolulu, HI

NPI 1467739474 · NPPES record last updated Nov 4, 2011

Key facts

NPI
1467739474
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
1492-09 (HI)
Practice address
1017C Pawaa LN
Honolulu, HI 96826-2185
Phone
(808) 941-5869
Fax
(808) 941-2987
NPI assigned
Nov 4, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1492-09HIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Honolulu Family Therapy Centre Inc. Past
since Aug 11, 2004
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1492-09 HI Yes

Addresses

Primary practice location

1017C Pawaa LN
Honolulu, HI 96826-2185

Mailing address

1017C Pawaa LN
Honolulu, HI 96826-2185
Phone (808) 941-5869

Other providers in Honolulu, HI

All providers in Honolulu, HI · Addiction (Substance Use Disorder) Counselor in Hawaii

Sources for this page

Verify at the official NPI Registry.