Active NPI
Susan Elizabeth Lopez, LPC, LMFT
- Counselor
- Fort Worth, TX
National Provider Identifier
1730452962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 65987
- Practice address
- 817 Coppin Dr
Fort Worth, TX 76120-2336 - Phone
- (469) 441-8707
- NPI assigned
- Feb 19, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 201385 | TX | |
| Counselor | 101Y00000X | 65987 | Primary |
Addresses
Primary practice location
817 Coppin Dr
Fort Worth, TX 76120-2336
Mailing address
817 Coppin Dr
Fort Worth, TX 76120-2336
Phone (469) 441-8707
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 |
|---|---|---|---|
| 201385 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1730452962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 COPPIN DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761202336",
"telephone_number": "469-441-8707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "817 COPPIN DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761202336",
"telephone_number": "469-441-8707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"credential": "LPC, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-19",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "201385",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": "65987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.