MEDICARE: LORA KINGSLEY M.S., LPC

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
1	101YP2500X	Professional Counselor	70592	TX

General Provider Information

NPI Number	:	1518200294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORA KINGSLEY M.S., LPC

Provider Business Mailing Address
First Line	:	8105 RASOR BLVD STE 238
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-0154
Country	:	US
Telephone Number	:	214-402-0981
Fax Number	:	214-276-7342

Provider Business Practice Location Address
First Line	:	8105 RASOR BLVD STE 238
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-0154
Country	:	US
Telephone Number	:	214-402-0981
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2013
Last Update Date	:	09/06/2023

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