Provider Demographics
NPI:1588899561
Name:LOPEZ-HEAGY, ANGELICA (MSW, LSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:
Last Name:LOPEZ-HEAGY
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:ANGELICA
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:110 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1123
Mailing Address - Country:US
Mailing Address - Phone:717-230-3919
Mailing Address - Fax:
Practice Address - Street 1:110 S 17TH ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1123
Practice Address - Country:US
Practice Address - Phone:717-230-3919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0177211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical