MEDICARE: CASIE LOPEZ LCSW, LCACA

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	34012521A	IN
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	87900154A	IN

General Provider Information

NPI Number	:	1700740628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASIE LOPEZ LCSW, LCACA

Provider Business Mailing Address
First Line	:	7112 SPURRINGTON CIR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-5115
Country	:	US
Telephone Number	:	317-982-2193
Fax Number	:

Provider Business Practice Location Address
First Line	:	7112 SPURRINGTON CIR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-5115
Country	:	US
Telephone Number	:	317-982-2193
Fax Number	:

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

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	02/10/2026

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