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NPI Code Detail

MEDICARE: LORI DRAPER LCSW

MEDICARE: LORI DRAPER 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 Worker10453769-3501UT

General Provider Information

NPI Number : 1952704207
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI DRAPER LCSW
Provider Business Mailing Address
First Line : 3075 E KENNEDY DR APT 301
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-2151
Country : US
Telephone Number : 646-544-1744
Fax Number :
Provider Business Practice Location Address
First Line : 724 E 2100 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84106-1830
Country : US
Telephone Number : 801-487-0499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2014
Last Update Date : 12/05/2022

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