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General NPI Number Information
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NPI Number | 1497682074
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Entity Type | Individual
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Provider Name | TAMMIE RENEE LOPEZ CADC-I, CPGC-I
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Gender | Female
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 1334 S MARYLAND PKWY STE 3
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City | LAS VEGAS
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State | NV
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Zip | 89104-3310
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Country | US
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Telephone | 818-455-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 SWEENEY AVE
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City | LAS VEGAS
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State | NV
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Zip | 89104-1660
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 08204-I
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 08203-IG
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License Number State | NV
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