Provider Demographics
NPI:1194009134
Name:ANDREA Z LOPES LCSW
Entity Type:Organization
Organization Name:ANDREA Z LOPES LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:LOPES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:301-570-7500
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20861-0157
Mailing Address - Country:US
Mailing Address - Phone:301-570-9700
Mailing Address - Fax:301-260-2838
Practice Address - Street 1:2915 OLNEY SANDY SPRING RD
Practice Address - Street 2:STE B
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1531
Practice Address - Country:US
Practice Address - Phone:301-570-7500
Practice Address - Fax:301-570-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD110951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1518152982OtherINDIVIDUAL NPI