Gilbert A Lopez, CSW
Individual provider Active NPI Counselor · Santa Rosa, NM
NPI 1831760883 · NPPES record last updated Jul 9, 2021
Key facts
- NPI
- 1831760883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1047 Lake Dr
Santa Rosa, NM 88435-2561 - Phone
- (575) 512-6154
- Fax
- (575) 472-5384
- NPI assigned
- Jul 9, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
1047 Lake Dr
Santa Rosa, NM 88435-2561
Mailing address
1047 Lake Dr
Santa Rosa, NM 88435-2561
Phone (572) 472-5383
Other providers in Santa Rosa, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.