Individual
ADENIA PEREZ LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1101 TYVOLA RD OFC 320, CHARLOTTE, NC 28217-3515
(980) 292-1855
Mailing address
1101 TYVOLA RD OFC 320, CHARLOTTE, NC 28217-3515
(917) 518-8404
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C012538
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00245029
—
NY
Enumeration date
10/09/2012
Last updated
11/13/2020
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