Provider Demographics
NPI:1942773122
Name:LOPEZ, VICKY NATALIE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:VICKY
Middle Name:NATALIE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 OAKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2240
Mailing Address - Country:US
Mailing Address - Phone:240-205-1744
Mailing Address - Fax:
Practice Address - Street 1:1000 TWINBROOK PKWY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20851-1201
Practice Address - Country:US
Practice Address - Phone:301-424-0656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD218021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical