Healthcare Provider Details

I. General information

NPI: 1760522965
Provider Name (Legal Business Name): LORI J BEHRENS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI AHRENS

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 NORTHPORT DR
ALTON IL
62002-5904
US

IV. Provider business mailing address

7519 PAUL LN
WORDEN IL
62097-2140
US

V. Phone/Fax

Practice location:
  • Phone: 618-466-0295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.021102
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number005209
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: