Healthcare Provider Details

I. General information

NPI: 1295366680
Provider Name (Legal Business Name): COURTNEY RENEE LORKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2020
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44899 CENTRE CT
CLINTON TWP MI
48038-5510
US

IV. Provider business mailing address

8811 HEDGEWAY DR
SHELBY TWP MI
48317-1620
US

V. Phone/Fax

Practice location:
  • Phone: 586-690-8331
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: