Healthcare Provider Details

I. General information

NPI: 1629598842
Provider Name (Legal Business Name): LORI VIEN LPCMH, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 S STATE ST
DOVER DE
19901-4945
US

IV. Provider business mailing address

1325 S STATE ST
DOVER DE
19901-4945
US

V. Phone/Fax

Practice location:
  • Phone: 302-405-2602
  • Fax:
Mailing address:
  • Phone: 302-405-2602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC-0000908
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: