Haseley Lopez, Jamie Leigh

Haseley Lopez, Jamie Leigh is an sole proprietor health care provider with primary practice located at 1528 Smoky Park Hwy , Candler NC 28715-9341. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Haseley Lopez, Jamie Leigh can be contacted via phone (415) 572-6450.

Contact Information

Primary practice address
1528 Smoky Park Hwy Candler NC 28715-9341
Phone: (415) 572-6450
Fax: (408) 890-4632
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 20042197A Indiana
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 20042197 Indiana
Behavioral Health & Social Service Providers / Psychologist 103T00000X 4338 North Carolina

Profile Details

NPI number 1164615456
LBN Legal business name Haseley Lopez, Jamie Leigh
Credentials PHD HSPP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 21st, 2007
Last updated Nov 28th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164615456 NPPES
Indiana MEDICAID 200903840

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