Provider Demographics
NPI:1336258094
Name:LOPEZ, ALBA C (LCSW,MSW)
Entity Type:Individual
Prefix:MS
First Name:ALBA
Middle Name:C
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LCSW,MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 JAMES AVE
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1212
Mailing Address - Country:US
Mailing Address - Phone:908-276-2667
Mailing Address - Fax:
Practice Address - Street 1:EAST ORANGE VETERAN'S HOSPITAL 385 TREMONT AVENUE
Practice Address - Street 2:MAIL STOP 118
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018
Practice Address - Country:US
Practice Address - Phone:973-676-1000
Practice Address - Fax:973-395-7186
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSL 483561041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool