Angel Lopez Clinic, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

ANGEL LOPEZ CLINIC, INC.

Practice address

2250 Satellite Blvd
Suite 175
Duluth, GA 30097

Phone

(770) 232-0555

Fax

(770) 232-0640

NPI assigned

Apr 14, 2008

Last updated

Feb 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sara Boucchechter

Title

Owner/President

Phone

(770) 232-0555

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Silvana M Gonzalez Rubio Acuna, LPC

  • Professional Counselor
  • Duluth, GA
  • NPI 1174113930
  NPD (past)
• Gabriela Beatriz Rodriguez, PHD

  • Clinical Psychologist
  • Duluth, GA
  • NPI 1093299828
  NPD (past)

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1972777654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 SATELLITE BLVD",
            "address_2": "SUITE 175",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-232-0555",
            "fax_number": "770-232-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 SATELLITE BLVD",
            "address_2": "SUITE 175",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-232-0555",
            "fax_number": "770-232-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL LOPEZ CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "BOUCCHECHTER",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "770-232-0555",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018244591B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan K Anderson, DMD
• Lucy Yelka Andia-Naylor
• Joseph Andrews, PHARMD
• Andronica Inc
• Angel Home, Inc.
• Anglea Slone DMD PC
• Latrisha Ankrum, RBT
• Annalise Robinson, LPC, LLC
• Annapurna Pharmacies, Inc (Pleasnt Hill Pharmacy)
• Taryn Anthony, PT, DPT

• Clinical Psychologist in Duluth, GA
• Providers in Duluth, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.

Verify at the official NPI Registry.