Provider Demographics
NPI:1699247700
Name:LOPEZ FRIEDRICH, EINRE ANNE IMPERIO (LCSW)
Entity type:Individual
Prefix:
First Name:EINRE ANNE
Middle Name:IMPERIO
Last Name:LOPEZ FRIEDRICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1949 GUNBARREL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3188
Mailing Address - Country:US
Mailing Address - Phone:423-495-4345
Mailing Address - Fax:423-495-4934
Practice Address - Street 1:957 BOYNTON DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-2118
Practice Address - Country:US
Practice Address - Phone:423-682-8150
Practice Address - Fax:423-682-8151
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN68131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical