Provider Demographics
NPI:1356168868
Name:LOPEZ, LINDSAY ANN (LTMFT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ANN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LTMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N ROCK RD STE 270
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2265
Mailing Address - Country:US
Mailing Address - Phone:316-300-8315
Mailing Address - Fax:
Practice Address - Street 1:250 N ROCK RD STE 270
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2265
Practice Address - Country:US
Practice Address - Phone:316-300-8315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMFT03644-T106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist