Healthcare Provider Details

I. General information

NPI: 1972274900
Provider Name (Legal Business Name): HANNAH LOPEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH BREWER LMSW

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705B OAK LN
VAN BUREN AR
72956-4816
US

IV. Provider business mailing address

PO BOX 11818
FORT SMITH AR
72917-1818
US

V. Phone/Fax

Practice location:
  • Phone: 479-471-5950
  • Fax: 479-471-5997
Mailing address:
  • Phone: 479-452-6650
  • Fax: 479-452-5847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13006-M
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13006-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: