MEDICARE: MR. ADOLFO L LOPEZ-QUINTERO LCSW, LCADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	37LC00303500	NJ
2	1041C0700X	Clinical Social Worker	44SC06384700	NJ

General Provider Information

NPI Number	:	1275822462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ADOLFO L LOPEZ-QUINTERO LCSW, LCADC

Provider Business Mailing Address
First Line	:	303 GEORGE ST STE 200
Second Line	:
City	:	NEW BRUNSWICK
State	:	NJ
Zip	:	08901-2009
Country	:	US
Telephone Number	:	908-458-5541
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 GEORGE ST STE 200
Second Line	:
City	:	NEW BRUNSWICK
State	:	NJ
Zip	:	08901-2009
Country	:	US
Telephone Number	:	908-458-5541
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2011
Last Update Date	:	11/05/2024

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