MEDICARE: SARAH ABIGAIL LOPEZ PLPC

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
1	101YM0800X	Mental Health Counselor	2023009520	MO

General Provider Information

NPI Number	:	1699476184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ABIGAIL LOPEZ PLPC

Provider Business Mailing Address
First Line	:	1811 SHERMAN DR STE 3
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-3976
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1811 SHERMAN DR STE 3
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-3976
Country	:	US
Telephone Number	:	314-577-0444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	03/13/2023

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