Individual
MR. SEBASTIAO IVAN LOPES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC, LADC
Contact information
Practice address
2323 S HARVARD AVE, TULSA, OK 74114-3301
(918) 293-2140
(918) 712-7164
Mailing address
2323 S HARVARD AVE, TULSA, OK 74114-3301
(918) 293-2140
(918) 712-7164
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3256
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
3256
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
522
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200365530A
—
OK
Enumeration date
07/13/2007
Last updated
04/03/2018
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