Jose Julian Lopez, L.S.A.A

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Velarde, NM

NPI 1790019545 · NPPES record last updated Sep 28, 2009

Key facts

NPI
1790019545
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
0064231 (NM)
Practice address
County Road 41 PVT Drive 1098
Velarde, NM 87582
Phone
(505) 852-2580
Fax
(505) 852-1827
NPI assigned
Sep 28, 2009
Sex
Male
Sole proprietor
Yes

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
0064231NMMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0064231 NM Yes

Addresses

Primary practice location

County Road 41 PVT Drive 1098
Velarde, NM 87582

Mailing address

P.O Box 520
Espanola, NM 87532
Phone (505) 852-2580

Other providers in Velarde, NM

All providers in Velarde, NM · Addiction (Substance Use Disorder) Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.