Individual provider · Type 1 NPI

Ivan Ricardo Lopez, LCSW

Clinical Social Worker · Bristol, FL

NPI number 1164058756 Active

Practice location

11033 NW State Road 20
Bristol, FL 32321-6406

Call (850) 643-1155 Map

Mailing address

5001 Lake Front Dr Apt B1
Tallahassee, FL 32303-7171

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X16852 (FL)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1164058756

Ivan Ricardo Lopez, LCSW's National Provider Identifier is 1164058756, issued on Mar 16, 2020. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Bristol, FL. The record was last updated on Mar 16, 2020.