MEDICARE: ALYSSA LOPEZ

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	103TC1900X	Counseling Psychologist		OH

General Provider Information

NPI Number	:	1184472391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA LOPEZ

Provider Business Mailing Address
First Line	:	20369 LORAIN RD APT D8
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44126-3454
Country	:	US
Telephone Number	:	517-902-6296
Fax Number	:

Provider Business Practice Location Address
First Line	:	3135 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-2531
Country	:	US
Telephone Number	:	216-391-2030
Fax Number	:

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

Provider Enumeration Date	:	05/13/2024
Last Update Date	:	02/09/2026

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Directions to “ ALYSSA LOPEZ ” Practice Location

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