Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ivan Ricardo Lopez, LCSW

Individual provider Clinical Social Worker · NPI 1164058756

Ivan Ricardo Lopez, LCSW is a Clinical Social Worker in Bristol, Florida. Qualified in 2016, 10 years ago. Practices with Community Health Center Inc, a 148-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
10
Licensed in
FL
In the registry since
2020
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

11033 NW State Road 20
Bristol, FL 32321-6406
Phone: (850) 643-1155
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 16852 (FL)

Record details

NPI number1164058756
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMarch 16, 2020
Last updated in NPPESMarch 16, 2020
Certification dateMarch 16, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Community Health Center Inc — 148 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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