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NPI Code Detail

MEDICARE: ANGELICA AMBERLY LOPEZ LCSW

MEDICARE: ANGELICA AMBERLY 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 WorkerSWB-2026-0155NM
21041C0700XClinical Social Worker68765TX

General Provider Information

NPI Number : 1619714177
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELICA AMBERLY LOPEZ LCSW
Provider Business Mailing Address
First Line : 2120 67TH ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79412-3808
Country : US
Telephone Number : 575-202-8792
Fax Number :
Provider Business Practice Location Address
First Line : 2120 67TH ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79412-3808
Country : US
Telephone Number : 575-202-8792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2024
Last Update Date : 02/25/2026

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Directions to “ ANGELICA AMBERLY LOPEZ LCSW” Practice Location

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