Individual ProviderOthoniel LopezSocial WorkerBehavioral Health & Social Service ProvidersPractice Address217 Havemeyer St, 4th Fl, Brooklyn, NY 11211-6277(718) 963-4430PECOS EnrollmentBased on the most recent information from CMS, provider Othoniel Lopez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1295031771Provider TypeIndividualFull NameLopez, OthonielCredentialMSWGenderMaleSole ProprietorNoEnumeration Date2/1/2011Last Updated12/19/2025Contact InformationPractice LocationPractice Address217 Havemeyer St, 4th Fl, Brooklyn, NY 11211-6277Phone(718) 963-4430Fax(718) 963-0814Mailing LocationMailing Address145 W 15th St Fl 2, New York, NY 10011-6701Phone(718) 963-4430Fax(718) 963-0814Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseCSW006681Georgia