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General NPI Number Information
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NPI Number | 1710669460
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Entity Type | Individual
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Provider Name | MELISSA ANDREA LOPEZ MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 1200 ROUTE 46 STE 210
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City | CLIFTON
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State | NJ
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Zip | 07013-2452
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Country | US
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Telephone | 845-507-6787
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Fax |
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Provider Business Mailing Address
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Address Line | 236 PUTNAM ST
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City | PATERSON
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State | NJ
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Zip | 07524-2526
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Country | US
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Telephone | 973-248-7139
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06982000
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License Number State | NJ
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