Healthcare Provider Details

I. General information

NPI: 1699476184
Provider Name (Legal Business Name): SARAH ABIGAIL LOPEZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH ABIGAIL LOPEZ LPC

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9666 OLIVE BLVD STE 370
SAINT LOUIS MO
63132-3025
US

IV. Provider business mailing address

9666 OLIVE BLVD STE 370
SAINT LOUIS MO
63132-3025
US

V. Phone/Fax

Practice location:
  • Phone: 314-681-6815
  • Fax:
Mailing address:
  • Phone: 314-681-6815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2023009520
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: