Individual provider Active NPI

Nicole Anne Lopez, LPC LAC ADC

  • Professional Counselor
  • Greenville, SC
National Provider Identifier
1912340084
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6828 Issued in SC
Practice address
30 Hampton Ave
Greenville, SC 29601
Phone
(864) 999-8957
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 6828 SC Primary

Addresses

Primary practice location

30 Hampton Ave
Greenville, SC 29601

Mailing address

30 Hampton Ave
Greenville, SC 29601
Phone (864) 999-8957

Other names 1

  • Ms. Nicole Newman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 1, 2024 through Aug 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6828SCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lopez Counseling Services LLC Professional CurrentSince Aug 18, 2024 Accepting new patients

Locations

30 Hampton Ave
Greenville, SC 29601
Phone (864) 729-0577

Organizations & group practices 1

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1912340084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HAMPTON AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29601",
            "telephone_number": "864-999-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HAMPTON AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29601",
            "telephone_number": "864-999-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LPC LAC ADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "6828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "NEWMAN",
            "prefix": "MS.",
            "credential": "LPC LAC ADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.