IndividualActive
Ivan Lopez, LCSW
NPI 1164058756 · Clinical Social Worker · Bristol, FL
Provider details
- NPI number
- 1164058756
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- License
- 16852 (FL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11033 Nw State Road 20
Bristol, FL 32321-6406
Phone: (850) 643-1155
Street-level locationGet directions
Mailing address
5001 Lake Front Dr Apt B1
Tallahassee, FL 32303-7171
Registry dates
- Enumerated
- 2020-03-16
- Last updated
- 2020-03-16
- Certified
- 2020-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.