Active NPI
Marisela Lopez, LP
- Psychologist
- New Haven, CT
National Provider Identifier
1699249987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 003763
- Practice address
- 66 Trumbull St # 1FF
New Haven, CT 06510-1012 - Phone
- (414) 436-9080
- NPI assigned
- Jan 19, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 003763 | CT | Primary |
Addresses
Primary practice location
66 Trumbull St # 1FF
New Haven, CT 06510-1012
Mailing address
14 Trumbull St Apt 302
New Haven, CT 06511-6312
Phone (414) 702-3148
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 |
|---|---|---|---|
| 003763 | CT | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547856000000",
"number": "1699249987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 TRUMBULL ST APT 302",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065116312",
"telephone_number": "414-702-3148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 TRUMBULL ST # 1FF",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065101012",
"telephone_number": "414-436-9080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MARISELA",
"credential": "LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-19",
"last_updated": "2019-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "003763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.