Provider Demographics
NPI:1215509740
Name:LOPEZ, MONIK (LMHC)
Entity type:Individual
Prefix:
First Name:MONIK
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 MADRUGA AVE STE 314
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3070
Mailing Address - Country:US
Mailing Address - Phone:786-540-9793
Mailing Address - Fax:
Practice Address - Street 1:1550 MADRUGA AVE STE 314
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3070
Practice Address - Country:US
Practice Address - Phone:786-540-9793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18295101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health