MEDICARE: MRS. LORI CHRISTINE MCCONNELL MS, LMHC, NCC

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	174400000X	Specialist	LH00008238	WA

General Provider Information

NPI Number	:	1720215338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI CHRISTINE MCCONNELL MS, LMHC, NCC

Provider Business Mailing Address
First Line	:	3213 CALIFORNIA AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-3304
Country	:	US
Telephone Number	:	206-349-3625
Fax Number	:	206-933-2687

Provider Business Practice Location Address
First Line	:	3213 CALIFORNIA AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-3304
Country	:	US
Telephone Number	:	206-349-3625
Fax Number	:	206-933-2687

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

Provider Enumeration Date	:	06/22/2009
Last Update Date	:	06/22/2009

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