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NPI Code Detail

MEDICARE: GREGORY C LORENZ LCSW

MEDICARE: GREGORY C LORENZ LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34004620AIN

General Provider Information

NPI Number : 1437142502
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY C LORENZ LCSW
Provider Business Mailing Address
First Line : 6626 E 75TH ST
Second Line : STE 500
City : INDIANAPOLIS
State : IN
Zip : 46250-2805
Country : US
Telephone Number : 317-621-7561
Fax Number : 317-355-6096
Provider Business Practice Location Address
First Line : 2040 N SHADELAND
Second Line : SUITE 200
City : INDIANAPOLIS
State : IN
Zip : 46219-1734
Country : US
Telephone Number : 317-355-1800
Fax Number : 317-355-1803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2005
Last Update Date : 03/12/2014

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Directions to “ GREGORY C LORENZ LCSW” Practice Location

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