Provider Demographics
NPI:1407212434
Name:LOPEZ, CHRISTINA M (LCSW, CADC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10855 BIGHORN DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89508
Mailing Address - Country:US
Mailing Address - Phone:775-287-4421
Mailing Address - Fax:
Practice Address - Street 1:480 GALLETTI WAY UNIT 25
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-5560
Practice Address - Country:US
Practice Address - Phone:775-688-2009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00785-C101YA0400X
NV11086-C1041C0700X
NVIC-1785104100000X, 1041C0700X
NV9019-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV14295635Medicaid