Individual provider Active NPI

Javier Francisco Lopez, MHC-LP

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1740823541
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
102502-01 Issued in NY
Practice address
102 Pilling St
Brooklyn, NY 11207-1610
Phone
(718) 602-1000
NPI assigned
Oct 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 102502-01 NY Primary

Addresses

Primary practice location

102 Pilling St
Brooklyn, NY 11207-1610

Mailing address

87 Columbia St Apt 11C
New York, NY 10002-1916
Phone (917) 259-9609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241122002930 NY Practitioner - Mental Health Counselor 9436684719 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102502-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center CurrentSince Nov 6, 2024 Accepting new patients
Coordinated Behavioral Care Ipa Inc PastSince Jul 25, 2021 Accepting new patients

Locations

102 Pilling St
Brooklyn, NY 11207
Phone (718) 602-1000

2857 Linden Blvd
Brooklyn, NY 11208
Phone (718) 235-3100

17620 148th Ave
Jamaica, NY 11434
Phone (718) 553-1100

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1740823541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 COLUMBIA ST APT 11C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100021916",
            "telephone_number": "917-259-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PILLING ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112071610",
            "telephone_number": "718-602-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JAVIER",
        "middle_name": "FRANCISCO",
        "name_prefix": "Mr.",
        "credential": "MHC-LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-24",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "102502-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.