Provider Demographics
NPI:1821334186
Name:LOPEZ, LINDA ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 OPELOUSAS ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-2641
Mailing Address - Country:US
Mailing Address - Phone:337-439-9983
Mailing Address - Fax:337-310-1161
Practice Address - Street 1:500 PATTERSON ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-1849
Practice Address - Country:US
Practice Address - Phone:337-769-9451
Practice Address - Fax:337-769-9460
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA90361041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical