MEDICARE: ERICA LOPEZ-LINTON MSW, LSW

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1285303164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA LOPEZ-LINTON MSW, LSW

Provider Business Mailing Address
First Line	:	1935 CANDLELIGHT CIR
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538-3501
Country	:	US
Telephone Number	:	630-885-1671
Fax Number	:

Provider Business Practice Location Address
First Line	:	1935 CANDLELIGHT CIR
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538-3501
Country	:	US
Telephone Number	:	630-885-1671
Fax Number	:

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

Provider Enumeration Date	:	09/13/2021
Last Update Date	:	02/16/2023

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