Provider Demographics
NPI:1265322937
Name:LOPEZ, RUBEN MANUEL III (LPC)
Entity type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:MANUEL
Last Name:LOPEZ
Suffix:III
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 W CRAIG PL APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-3466
Mailing Address - Country:US
Mailing Address - Phone:708-658-4672
Mailing Address - Fax:
Practice Address - Street 1:4718 147TH ST
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:IL
Practice Address - Zip Code:60445-2527
Practice Address - Country:US
Practice Address - Phone:708-658-4672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-05
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health