MEDICARE: KRISTOPHER AMOS-LOPEZ LPC

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	101YP2500X	Professional Counselor	6401018172	MI

General Provider Information

NPI Number	:	1811434277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTOPHER AMOS-LOPEZ LPC

Provider Business Mailing Address
First Line	:	702 S CANAL RD
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-9644
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	463 E CIRCLE DR
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48824-7500
Country	:	US
Telephone Number	:	517-614-0618
Fax Number	:

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

Provider Enumeration Date	:	01/24/2017
Last Update Date	:	02/13/2026

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