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NPI Code Detail

MEDICARE: MR. SEBASTIAO IVAN LOPES MS, LPC, LADC

MEDICARE: MR. SEBASTIAO IVAN LOPES MS, LPC, LADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor3256OK
2101YA0400XAddiction (Substance Use Disorder) Counselor522OK
3101Y00000XCounselor3256OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528267119
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SEBASTIAO IVAN LOPES MS, LPC, LADC
Provider Business Mailing Address
First Line : 2323 S HARVARD AVE
Second Line :
City : TULSA
State : OK
Zip : 74114-3301
Country : US
Telephone Number : 918-293-2140
Fax Number : 918-712-7164
Provider Business Practice Location Address
First Line : 2323 S HARVARD AVE
Second Line :
City : TULSA
State : OK
Zip : 74114-3301
Country : US
Telephone Number : 918-293-2140
Fax Number : 918-712-7164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2007
Last Update Date : 04/03/2018

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