Individual
LEON DAVID LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, LMSW
Contact information
Practice address
2068 VEREDA JOSEFITA, SANTA FE, NM 87507-3310
(505) 920-2323
Mailing address
2068 VEREDA JOSEFITA, SANTA FE, NM 87507-3310
(505) 920-2323
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
102X00000X
Poetry Therapist
—
—
104100000X
Social Worker
Primary
M-08362
NM
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
08/12/2021
Last updated
08/12/2021
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