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Individual

JAMES LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CASAC - T

Contact information

Practice address
273 HEBERTON AVE, STATEN ISLAND, NY 10302-1809
(718) 412-3170
Mailing address
273 HEBERTON AVE, STATEN ISLAND, NY 10302-1809
(718) 412-3170

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
38388
NY

Other

Enumeration date
06/30/2025
Last updated
06/30/2025
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