Provider Demographics
NPI:1578724332
Name:LOPEZ, NEDA (LCSW, CSAC)
Entity Type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LCSW, CSAC
Other - Prefix:
Other - First Name:NEDA
Other - Middle Name:
Other - Last Name:LOPEZ-GADSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, CSAC
Mailing Address - Street 1:1425 BATTLEFIELD BLVD N STE 2182
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4585
Mailing Address - Country:US
Mailing Address - Phone:757-524-0797
Mailing Address - Fax:757-296-6082
Practice Address - Street 1:1425 BATTLEFIELD BLVD N STE 2182
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4585
Practice Address - Country:US
Practice Address - Phone:757-524-0797
Practice Address - Fax:757-823-4265
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040073941041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1306800198Medicaid