Provider Demographics
NPI:1548854722
Name:LOPES, ELISANDRA
Entity type:Individual
Prefix:
First Name:ELISANDRA
Middle Name:
Last Name:LOPES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 COCASSET ST APT 1
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2946
Mailing Address - Country:US
Mailing Address - Phone:774-417-1691
Mailing Address - Fax:
Practice Address - Street 1:31 COCASSET ST APT 1
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2946
Practice Address - Country:US
Practice Address - Phone:774-417-1691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-27
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health