=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356294482
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NELLY LOPEZ MSW-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2026
-----------------------------------------------------
Last Update Date | 02/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CARR. 1 INT. 795 KM 2.0 BO. LA MESA SECT. EL CAMARON
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-371-7629
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | HC 9 BOX 61117
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725-9249
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-371-7629
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 16207
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------