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NPI Code Detail

MEDICARE: MELISSA LOPEZ LCSW

MEDICARE: MELISSA LOPEZ 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
11041C0700XClinical Social Worker37626TX

General Provider Information

NPI Number : 1497186944
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA LOPEZ LCSW
Provider Business Mailing Address
First Line : 2811 E 2ND ST
Second Line :
City : AUSTIN
State : TX
Zip : 78702-4843
Country : US
Telephone Number : 512-324-4957
Fax Number :
Provider Business Practice Location Address
First Line : 2811 E 2ND ST
Second Line :
City : AUSTIN
State : TX
Zip : 78702-4843
Country : US
Telephone Number : 512-324-4957
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2013
Last Update Date : 03/09/2022

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Directions to “ MELISSA LOPEZ LCSW” Practice Location

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