Individual provider Active NPI

Ashley Virginia Lopez, LSW

  • Clinical Social Worker
  • Passaic, NJ
National Provider Identifier
1679239594
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06308500 Issued in NJ
Practice address
28 Aycrigg Ave Apt 2
Passaic, NJ 07055-5609
Phone
(862) 900-9146
NPI assigned
Nov 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL06261400 NJ
Clinical Social Worker 1041C0700X 44SC06308500 NJ Primary

Addresses

Primary practice location

28 Aycrigg Ave Apt 2
Passaic, NJ 07055-5609

Mailing address

28 Aycrigg Ave Apt 2
Passaic, NJ 07055-5609
Phone (862) 900-9146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240503001519 NJ Practitioner - Clinical Social Worker 2466892765 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL06261400NJMDSocial Worker
44SC06308500NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Olivo Therapy Group CurrentSince Apr 16, 2024 Accepting new patients

Locations

290 Chestnut St
Newark, NJ 07105
Phone (973) 545-6767

Interoperability endpoints

  • Direct secure messaging: ashley.lopez@597174495543300.direct.elationemr.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1679239594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 AYCRIGG AVE APT 2",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555609",
            "telephone_number": "862-900-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 AYCRIGG AVE APT 2",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555609",
            "telephone_number": "862-900-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ASHLEY",
        "middle_name": "VIRGINIA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06261400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06308500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.