Provider Demographics
NPI:1467189522
Name:LOPEZ, CHELSEY LYNN (LCSW-A)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:LYNN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 CEDAR ISLAND TRL
Mailing Address - Street 2:
Mailing Address - City:HOLLY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28445-7512
Mailing Address - Country:US
Mailing Address - Phone:518-791-8871
Mailing Address - Fax:
Practice Address - Street 1:1540 E ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5870
Practice Address - Country:US
Practice Address - Phone:280-625-2364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPO171281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical