MEDICARE: JOSSELYN LOPEZ LPC

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	101YP2500X	Professional Counselor	24114	AZ

General Provider Information

NPI Number	:	1972481760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSSELYN LOPEZ LPC

Provider Business Mailing Address
First Line	:	11107 W INDIANA AVE
Second Line	:
City	:	YOUNGTOWN
State	:	AZ
Zip	:	85363-1547
Country	:	US
Telephone Number	:	602-541-2727
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 N CENTRAL AVE STE 1050
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1217
Country	:	US
Telephone Number	:	602-266-8402
Fax Number	:

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

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	08/21/2025

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