Charity R Lopez, MSW,LCSW, CSAC, CSIT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11160123 Issued in WI

Practice address

30401 Mountain LN
Waterford, WI 53185-3442

Phone

(262) 455-4018

NPI assigned

May 1, 2024

Last updated

May 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1053168799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30401 MOUNTAIN LN",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531853442",
            "telephone_number": "765-618-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30401 MOUNTAIN LN",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531853442",
            "telephone_number": "262-455-4018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9916 75th St",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531427583",
            "country_code": "US",
            "telephone_number": "262-455-4018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "CHARITY",
        "middle_name": "R",
        "credential": "MSW,LCSW, CSAC, CSIT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17092132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11160123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Edward J Lesniak, PTA
• Jennifer Lucas
• Ashley Lucht, OTR/L
• Mustansir Majeed, MD
• Lamberto Y Malinis Jr., MD
• Lauren Mallison, RN, BSN

• Clinical Social Worker in Waterford, WI
• Providers in Waterford, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.