Provider Demographics
NPI:1588172720
Name:LEIVA LOPEZ, ZUCEL (BS, MED, LMHC)
Entity type:Individual
Prefix:
First Name:ZUCEL
Middle Name:
Last Name:LEIVA LOPEZ
Suffix:
Gender:F
Credentials:BS, MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 POWDERMILL RD STE 213
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-5932
Mailing Address - Country:US
Mailing Address - Phone:978-393-1028
Mailing Address - Fax:
Practice Address - Street 1:100 POWDERMILL RD STE 213
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-5932
Practice Address - Country:US
Practice Address - Phone:978-305-1847
Practice Address - Fax:978-268-5082
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health