MEDICARE: MRS. LUZ DIVINA LOPEZ-KNICRUMAH LCSW

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	SW10803	FL
2	101YM0800X	Mental Health Counselor	SW10803	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427492438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LUZ DIVINA LOPEZ-KNICRUMAH LCSW

Provider Business Mailing Address
First Line	:	13350 W COLONIAL DR STE 340
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-3977
Country	:	US
Telephone Number	:	407-654-4433
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 SAVAGE CT STE 101
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4988
Country	:	US
Telephone Number	:	407-250-3452
Fax Number	:

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

Provider Enumeration Date	:	04/21/2013
Last Update Date	:	04/21/2026

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