Provider Demographics
NPI:1861048381
Name:LOPEZ, LORNA E (MSW)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:E
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9809
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9809
Mailing Address - Country:US
Mailing Address - Phone:787-704-0705
Mailing Address - Fax:787-744-7444
Practice Address - Street 1:CARR 926 KM 0 HM 6 INT
Practice Address - Street 2:BO COLLORES
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00761
Practice Address - Country:US
Practice Address - Phone:787-425-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR127741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty