Provider Demographics
NPI:1669150306
Name:LOPEZ, CINDI (LSW)
Entity type:Individual
Prefix:
First Name:CINDI
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MINTLEAF RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19056-3625
Mailing Address - Country:US
Mailing Address - Phone:215-791-4962
Mailing Address - Fax:
Practice Address - Street 1:112 E ALLEN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-4189
Practice Address - Country:US
Practice Address - Phone:215-791-4962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140172104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker