Active NPI
Edgar Antonio Lopez, BA/MSW
- Mental Health Counselor
- Long Beach, CA
National Provider Identifier
1952956971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW95990
- Practice address
- 850 E Wardlow Rd
Long Beach, CA 90807-4628 - Phone
- (562) 981-9392
- NPI assigned
- Aug 6, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CA | ||
| Mental Health Counselor | 101YM0800X | 95990 | CA | |
| Mental Health Counselor | 101YM0800X | ASW95990 | CA | Primary |
Addresses
Primary practice location
850 E Wardlow Rd
Long Beach, CA 90807-4628
Mailing address
850 E Wardlow Rd
Long Beach, CA 90807-4628
Phone (562) 981-9392
Other practice location 1
29019 Carillo Ct
Moreno Valley, CA 92555-6501
Phone (951) 488-0611
Other practice location 2
161 W Victoria St
Long Beach, CA 90805-2175
Phone (323) 242-5000
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW95990 | CA | MD | Mental Health Counselor |
| 95990 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632268800000",
"number": "1952956971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 E WARDLOW RD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908074628",
"telephone_number": "562-981-9392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 E WARDLOW RD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908074628",
"telephone_number": "562-981-9392"
}
],
"practiceLocations": [
{
"address_1": "29019 Carillo Ct",
"address_purpose": "LOCATION",
"city": "Moreno Valley",
"state": "CA",
"postal_code": "925556501",
"country_code": "US",
"telephone_number": "951-488-0611",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "161 W Victoria St",
"address_purpose": "LOCATION",
"city": "Long Beach",
"state": "CA",
"postal_code": "908052175",
"country_code": "US",
"telephone_number": "323-242-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOPEZ",
"first_name": "EDGAR",
"middle_name": "ANTONIO",
"credential": "BA/MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-06",
"last_updated": "2021-09-22",
"certification_date": "2021-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "95990",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW95990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.