Healthcare Provider Details

I. General information

NPI: 1013001783
Provider Name (Legal Business Name): LORI L. MEFFLEY MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N 7TH ST
CANON CITY CO
81212-3373
US

IV. Provider business mailing address

303 N 7TH ST
CANON CITY CO
81212-3373
US

V. Phone/Fax

Practice location:
  • Phone: 719-269-3229
  • Fax: 719-269-8328
Mailing address:
  • Phone: 719-269-3229
  • Fax: 719-269-8328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number992482
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: