Provider Demographics
NPI:1003123803
Name:LOPEZ, MELISSA (LCSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:ORZECHOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW, LSW
Mailing Address - Street 1:833 N PARK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1341
Mailing Address - Country:US
Mailing Address - Phone:610-396-5094
Mailing Address - Fax:484-854-0715
Practice Address - Street 1:833 N PARK RD STE 101
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1341
Practice Address - Country:US
Practice Address - Phone:610-396-5094
Practice Address - Fax:484-854-0715
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW022006101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health