MEDICARE: MICHAEL L 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1841029519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL L LOPEZ

Provider Business Mailing Address
First Line	:	23401 E 5TH DR APT 203
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80018-1605
Country	:	US
Telephone Number	:	720-375-0089
Fax Number	:

Provider Business Practice Location Address
First Line	:	7955 E ARAPAHOE CT
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-1358
Country	:	US
Telephone Number	:	720-772-8912
Fax Number	:

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

Provider Enumeration Date	:	07/30/2024
Last Update Date	:	07/31/2024

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