Individual
JUAN CARLOS LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
54-56 BOSTON POST ROAD, WILLIMANTIC, CT 06226
(860) 456-7990
Mailing address
2 WATERSIDE XING STE 401, WINDSOR, CT 06095-1588
(860) 731-5522
(860) 731-5536
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
7056
CT
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/03/2023
Last updated
03/28/2025
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