Juanita Dolores Lopez, MASTER OF SOCIAL WOR

Individual provider Active NPI Clinical Social Worker · Wheatridge, CO

NPI 1194087692 · NPPES record last updated Jun 11, 2012

Key facts

NPI
1194087692
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
4851 Independence St.
Suite 200
Wheatridge, CO 80033-6715
Phone
(303) 425-0300
Fax
(303) 432-5071
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

4851 Independence St.
Suite 200
Wheatridge, CO 80033-6715

Mailing address

4851 Independence Street Suite 200
Jefferson Center for Mental Health
Wheatridge, CO 80033-6715
Phone (303) 425-0300

Other providers in Wheatridge, CO

All providers in Wheatridge, CO · Clinical Social Worker in Colorado

Sources for this page

Verify at the official NPI Registry.