Provider Demographics
NPI:1063920171
Name:LOPEZ WRIGHT, FELICIA LOREN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:LOREN
Last Name:LOPEZ WRIGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:FELICIA
Other - Middle Name:LOREN
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 N FULTON ST APT 406
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2237
Mailing Address - Country:US
Mailing Address - Phone:201-341-2149
Mailing Address - Fax:
Practice Address - Street 1:67 SANFORD ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1926
Practice Address - Country:US
Practice Address - Phone:973-673-3342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057614001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical