Individual provider Active NPI

Cheryl Peggy Lopez, LCSW

  • Clinical Social Worker
  • White Plains, NY
National Provider Identifier
1710322391
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9377 Issued in CT
Practice address
75 S Broadway
Ste 404
White Plains, NY 10601-4413
Phone
(914) 565-4192
Fax
(914) 937-2568
NPI assigned
May 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 084733 NY
Clinical Social Worker 1041C0700X 9377 CT Primary

Addresses

Primary practice location

75 S Broadway
Ste 404
White Plains, NY 10601-4413

Mailing address

14 Fawcett St
Port Chester, NY 10573-5226
Phone (203) 308-1418

Other practice location 1

14 Fawcett St Apt 2
Port Chester, NY 10573-5226
Phone (203) 308-1418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170124001083 NY Practitioner - Clinical Social Worker 0042592248 Practice locations: White Plains, NY
I20210603000176 CT Practitioner - Clinical Social Worker 0042592248 Practice locations: Stamford, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

75 S Broadway
White Plains, NY 10601-4413
Phone (914) 565-4192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9377CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Multicultural Consciousness, LLC Social Worker CurrentSince Mar 22, 2020 Accepting new patients

Locations

1372 Summer St
Ste 203
Stamford, CT 06905
Phone (203) 308-1418

75 S Broadway
Ste 404
White Plains, NY 10601
Phone (914) 310-4404

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": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1710322391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FAWCETT ST",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105735226",
            "telephone_number": "203-308-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S BROADWAY",
            "address_2": "STE 404",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014413",
            "telephone_number": "914-565-4192",
            "fax_number": "914-937-2568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Fawcett St Apt 2",
            "address_purpose": "LOCATION",
            "city": "Port Chester",
            "state": "NY",
            "postal_code": "105735226",
            "country_code": "US",
            "telephone_number": "203-308-1418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "CHERYL",
        "middle_name": "PEGGY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084733",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "9377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.